Cerebral cortical atrophy and silent brain infarcts in psychiatric patients.

AIM: To assess the frequency of silent brain infarcts and cerebral cortical atrophy in psychiatric patients with cognitive dysfunction.

METHODS

One hundred and ninety four patients with cognitive dysfunction determined by the use of the Benton Visual Retention Test and Wechsler Memory Scale were analyzed according to age, gender, education, duration of psychiatric treatment, presence of mental disorders, neurological findings, and CT scan of neurocranium. The results were analyzed using descriptive statistics.

RESULTS

Average age of the group of patients studied was 48+/-9.7 years, and average duration of psychiatric treatment was 6+/-7.3 years. Regarding mental disorders, patients suffered from posttraumatic stress disorder (PTSD) in comorbidity with depression (21.1%), depressive disorder (14.4%), Complex PTSD (13.9%), PTSD (11.3%), and post-concussion syndrome (7.7%). Cerebral cortical atrophy was determined in 47.4%, silent brain infarct in 3.6%, whereas the combination of cerebral cortical atrophy and silent brain infarct was found in 26.3% of patients. In 22.6% of patients with cognitive dysfunction on the Benton Visual Retention Test and Wechsler Memory Scale CT scan findings were completely normal. Cerebral cortical atrophy was more frequent in patients with PTSD in comorbidity with depression (43%), PTSD (39.0%), Complex PTSD (26%), depression (25%), whereas the silent brain infarct was more frequent in patients with post-concussion syndrome (53.3%) and depression (42.8%).

CONCLUSION

Cerebral cortical atrophy and silent brain infarct are frequent findings in computerized tomography of the brain in psychiatric patients with cognitive dysfunction. Cerebral atrophy is frequent in patients with PTSD, whereas in patients with depression, besides cerebral atrophy, silent brain infarct is also frequently present.