Neutrophil Count Associated With Gray Matter and Cerebrospinal Fluid Volume in Psychosis

Neutrophil cell
Neutrophil cell
Investigators sought to determine whether blood cell count was associated with brain volume and clinical symptomatology.

A reduction in the volume of gray matter and an increase in cerebrospinal fluid are related to a higher neutrophil count in patients with first-episode psychosis, according to a study published in Schizophrenia Bulletin.

Researchers evaluated patients with first-episode psychosis (n=137) and healthy controls (n=81) for demographic data, structural brain images, blood analysis, and clinical evaluations and the associations between these factors and psychosis. Brain images were used to calculate grey matter, white matter, cerebrospinal fluid, and total brain volume. Clinical evaluation included use of the Positive and Negative Syndrome Scale and the Symptom Onset in Schizophrenia scale.

Results indicated that patients with first-episode psychosis had lower grey matter volume, higher cerebrospinal fluid volume, higher blood neutrophil count, and lower erythrocyte count when compared with healthy controls. Regression analyses signified that neutrophil counts were most selectively associated with cerebrospinal fluid volume in patients with first-episode psychosis (89.2%) and associated with reduced volume of the thalamus (P=.005), entorhinal area (P=.002), and anterior insula (P=.019) and increased volume of the lateral ventricle (P=.010) and third ventricle (P=.062). Researchers also found associations between neutrophil count and total Positive and Negative Syndrome Scale scores (P<.001), hallucinations (P=.028), suspiciousness (P<.001), hostility (P=.005), disturbance of volition (P=.018), and preoccupation (P<.001).

Future studies need to assess the specific mechanism for this relationship, whether neutrophil count could be used to indicate severity of psychosis in schizophrenia, and whether a therapy controlling neutrophils could improve disease conditions.

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In conclusion, this study presented results that show an association between neutrophil count and reduced grey matter volume and increased cerebrospinal fluid, indicating a potential autoimmune component to psychosis.  In addition, researchers wrote, “neutrophil count is proposed as an indicator of psychosis severity, and may give rise to new therapeutic options addressing neutrophils or the neutrophil immune response.”

This study was supported by Ministerio de Economía y Competitividad. Please refer to reference for a complete list of authors’ disclosures.


Núñez C, Stephan-Otto C, Usall J, et al. Neutrophil count is associated with reduced gray matter and enlarged ventricles in first-episode psychosis. [published online Aug. 10, 2018] Schizophr Bull. doi: 10.1093/schbul/sby113