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The Corpus Callosum in Schizoaffective Disorder: A Shape Analysis Study

Year 2024, Volume: 14 Issue: 3, 691 - 697, 30.09.2024
https://doi.org/10.33808/clinexphealthsci.1323653

Abstract

Objective: The corpus callosum is the largest white matter structure in the human brain that connects the cortical regions of both hemispheres. Diseases could lead to degenerative alterations in brain structures such as the corpus callosum (CC). Studies have associated CC abnormalities with Schizoaffective Disorder (SAD) symptoms. We predicted that there may be differences in the CC, an important structure connecting the two halves of the brain, in patients with SAD. The present study aims to analyze the CC of patients with statistical
shape analysis (SSA) and compare the findings with healthy controls.
Methods: Thirty-nine SAD patients and 39 healthy individuals (11 females and 28 males) of similar age that included subjects participated in the study. CC landmarks were marked on the mid-sagittal images of each participant. The mean ‘Procrustes’ point was determined, and shape deformations were analyzed with thin plate spline analysis.
Results: Significant differences were observed between the shapes of CC in the two groups, and maximum CC deformation was observed in the posterior regions of SAD patients. There was no significant difference between the CC area of the SAD patients and the controls.
Conclusion: In the present study, the maximum deformation was observed in the posterior region (isthmus and splenium) and the rostrum of the CC. The first CC region, the rostrum (+genu), connects prefrontal and premotor regions, which are associated with cognitive information (landmarks = 1, 7, 8, 9, 13, 15, and 12). The second area, the splenium, connects temporal and occipital cortical areas. These predominantly
have auditory, peripheral, and central visual stimulation functions (landmarks = 5, 3, and 4). The current study could assist future studies on the etiology, diagnosis, and treatment of SAD.

References

  • Miller NS, Cocores JA, Belkin B. Schizoaffective disorder: A review. Ann Clin Psychiatry. 2019;31(1):47-53. DOI:10.3109/10401239109147967
  • Malaspina D, Owen MJ, Heckers S, Tandon R, Bustillo J, Schultz S, Barch DM, Gaebel W, Gur RE, Tsuang M, Van Os J, Carpenter W. Schizoaffective disorder in the DSM-5. Schizophr Res. 2013;150(1):21-25. DOI:10.1016/J.SCHRES.2013.04.026
  • Van der Knaap LJ, van der Ham IJM. How does the corpus callosum mediate interhemispheric transfer? A review. Behavioural Brain Research. 2011;223(1):211-221. DOI:10.1016/J.BBR.2011.04.018
  • Frumin M, Golland P, Kikinis R, Hirayasu Y, Salisbury DF, Hennen J, Dickey CC, Anderson M, Jolesz FA, Grimson WE, McCarley RW, Shenton ME. Shape differences in the corpus callosum in first-episode schizophrenia and first-episode psychotic affective disorder. Am J Psychiatry. 2002 May;159(5):866-868. DOI: 10.1176/appi.ajp.159.5.866.
  • Cyprien F, Courtet P, Malafosse A, Maller J, Meslin C, Bonafé A, Le Bars E, de Champfleur NM, Ritchie K, Artero S. Suicidal behavior is associated with reduced corpus callosum area. Biol Psychiatry. 2011 Aug 15;70(4):320-326. DOI: 10.1016/j.biopsych.2011.02.035.
  • Vermeulen CL, du Toit PJ, Venter G, Human-Baron R. A morphological study of the shape of the corpus callosum in normal, schizophrenic and bipolar patients. J Anat. Published online 2022. DOI:10.1111/JOA.13777
  • Styner M, Gerig G, Lieberman J, Jones D, Weinberger D. Statistical shape analysis of neuroanatomical structures based on medial models. Med Image Anal. 2003;7(3):207-220. DOI:10.1016/S1361-8415(02)00110-X
  • Özdemir ST, Ercan I, Sevinc O, Guney I, Ocakoglu G, Aslan E, Barut C. Statistical shape analysis of differences in the shape of the corpus callosum between genders. Anat Rec (Hoboken). 2007 Jul;290(7):825-830. DOI: 10.1002/ar.20558.
  • Türk Y, Ercan I, Sahin I, et al. Corpus callosum in schizophrenia with deficit and non-deficit syndrome: A statistical shape analysis. Gen Psychiatr. 2021;34(6):100635. DOI:10.1136/GPSYCH-2021-10063512.
  • Joshi SH, Narr KL, Philips OR, Nuechterlein KH, Asarnow RF, Toga AW, Woods RP. Statistical shape analysis of the corpus callosum in Schizophrenia. Neuroimage. 2013 Jan 1;64:547-559. DOI: 10.1016/j.neuroimage.2012.09.024.
  • Sarrazin S, d'Albis MA, McDonald C, Linke J, Wessa M, Phillips M, Delavest M, Emsell L, Versace A, Almeida J, Mangin JF, Poupon C, Le Dudal K, Daban C, Hamdani N, Leboyer M, Houenou J. Corpus callosum area in patients with bipolar disorder with and without psychotic features: An international multicentre study. J Psychiatry Neurosci. 2015 Sep;40(5):352-359. DOI: 10.1503/jpn.140262.
  • Sigirli D, Ercan I, Ozdemir ST, Taskapilioglu O, Hakyemez B, Turan OF. Shape analysis of the corpus callosum and cerebellum in female MS patients with different clinical phenotypes. Anat Rec (Hoboken). 2012 Jul;295(7):1202-1211. DOI: 10.1002/ar.22493.
  • Jiang Z, Yang H, Tang X. Deformation-based Statistical Shape Analysis of the Corpus Callosum in Mild Cognitive Impairment and Alzheimer's Disease. Curr Alzheimer Res. 2018;15(12):1151-1160. DOI: 10.2174/1567205015666180813145935.
  • He Q, Duan Y, Miles J, Takahashi N. Statistical shape analysis of the corpus callosum in subtypes of autism. Proceedings of the 7th IEEE International Conference on Bioinformatics and Bioengineering, BIBE. Published online 2007:1087-1091. DOI:10.1109/BIBE.2007.4375694
  • Sigirli D, Gunes A, Turan Ozdemir S, Ercan I, Durmus Y, Erdemli Gursel B. Statistical shape analysis of corpus callosum in restless leg syndrome.2020;42(9):760-766. DOI:10.1080/01616412.2020.1773631
  • Colak C, Ercan I, Dogan M, Ozdemir ST, Sener S, Alkan A. Detecting the shape differences of the corpus callosum in Behçet’s Disease by statistical shape analysis. Anatomical Record. 2011;294(5):870-874. DOI:10.1002/AR.21373
  • American Psychiatric Association and American Psychiatric Association. DSM-5 Task Force., Diagnostic and statistical manual of mental disorders : DSM-5. 5th ed. 2013, Washington, D.C.: American Psychiatric Association. xliv, 947 p.
  • Baykara S, Baykara M, Atmaca M. Statistical shape analysis of corpus callosum in vaginismus. Archives of Psychiatry and Psychotherapy. 2023;25(2):37-44. DOI:10.12740/APP/155218
  • Baykara S, Baykara M, Atmaca M. Regular Islamic prayers have different corpus callosum: A shape analysis study. Egyptian Journal of Neurology, Psychiatry and Neurosurgery. 2023;59(1):1-8. DOI:10.1186/S41983-023-00683-X/FIGURES/4
  • Baykara M, Baykara S, Atmaca M. Statistical shape analysis of corpus callosum in functional neurological disorder. Neuropsychiatria i Neuropsychologia/Neuropsychiatry and Neuropsychology. 2022;17(1):1-8. DOI:10.5114/NAN.2022.117950
  • Zaken V, Kohen R, Ornoy A. Geometric morphometrics of corpus callosum and subcortical structures in the fetal-alcohol-affected brain. Teratology. 2001;64(1):4-32. DOI:10.1002/TERA.1044
  • Ozdemir ST, Ercan I, Sevinc O, Guney I, Ocakoglu G, Aslan E, Barut C. Statistical shape analysis of differences in the shape of the corpus callosum between genders. Anat Rec (Hoboken). 2007 Jul;290(7):825-830. DOI: 10.1002/ar.20558.
  • Rohlf FJ. The tps series of software. Hystrix. 2015;26(1):9-12.
  • Hammer Ø, Harper D, Ryan PD. Past: Paleontological statistics software package for education and data analysis. Palaeontologia Electronica. 2001;4(1):1.
  • Dryden IL, Mardia KV. Statistical Shape Analysis: With Applications in R. John Wiley & Sons; 2016.
  • Team, T.R.C., R. 2021, The R Foundation. p. Free Software Foundation’s GNU General Public License.29.
  • He Q, Duan Y, Karsch K, Miles J. Detecting corpus callosum abnormalities in autism based on anatomical landmarks. Psychiatry Res. 2010 Aug 30;183(2):126-132. DOI: 10.1016/j.pscychresns.2010.05.006. 30.
  • Kaya MO, Ozturk S, Ercan I, Gonen M, Serhat Erol F, Kocabicak E. Statistical shape analysis of subthalamic nucleus in patients with Parkinson Disease. World Neurosurg. 2019 Jun;126:e835-e841. DOI: 10.1016/j.wneu.2019.02.180.
  • Friedrich P, Forkel SJ, Thiebaut de Schotten M. Mapping the principal gradient onto the corpus callosum. Neuroimage. 2020 Dec;223:117317. DOI: 10.1016/j.neuroimage.2020.117317.
  • Fabri M, Polonara G. Functional topography of human corpus callosum: An FMRI mapping study. Neural Plast. 2013;2013:251308. DOI: 10.1155/2013/251308.
  • Chao YP, Cho KH, Yeh CH, Chou KH, Chen JH, Lin CP. Probabilistic topography of human corpus callosum using cytoarchitectural parcellation and high angular resolution diffusion imaging tractography. Hum Brain Mapp. 2009;30(10):3172-3187. DOI:10.1002/HBM.2073935.
  • Hofer S, Frahm J. Topography of the human corpus callosum revisited--comprehensive fiber tractography using diffusion tensor magnetic resonance imaging. Neuroimage. 2006 Sep;32(3):989-994. DOI: 10.1016/j.neuroimage.2006.05.044.
  • He Q, Duan Y, Karsch K, Miles J. Detecting corpus callosum abnormalities in autism based on anatomical landmarks. Psychiatry Res Neuroimaging. 2010;183(2):126-132. DOI:10.1016/j.pscychresns.2010.05.006
  • Francis AN, Mothi SS, Mathew IT, Tandon N, Clementz B, Pearlson GD, Sweeney JA, Tamminga CA, Keshavan MS. Callosal abnormalities across the psychosis dimension: Bipolar schizophrenia network on intermediate phenotypes. Biol Psychiatry. 2016 Oct 15;80(8):627-635. DOI: 10.1016/j.biopsych.2015.12.026.
  • Walterfang M, Wood AG, Reutens DC, Wood SJ, Chen J, Velakoulis D, McGorry PD, Pantelis C. Morphology of the corpus callosum at different stages of schizophrenia: Cross-sectional study in first-episode and chronic illness. Br J Psychiatry. 2008 Jun;192(6):429-34. DOI: 10.1192/bjp.bp.107.041251.
  • Landin-Romero R, Canales-Rodríguez EJ, Kumfor F, Moreno-Alcázar A, Madre M, Maristany T, Pomarol-Clotet E, Amann BL. Surface-based brain morphometry and diffusion tensor imaging in schizoaffective disorder. Aust N Z J Psychiatry. 2017 Jan;51(1):42-54. DOI: 10.1177/0004867416631827.
  • Madre M, Canales-Rodríguez EJ, Ortiz-Gil J, Murru A, Torrent C, Bramon E, Perez V, Orth M, Brambilla P, Vieta E, Amann BL. Neuropsychological and neuroimaging underpinnings of schizoaffective disorder: A systematic review. Acta Psychiatr Scand. 2016 Jul;134(1):16-30. DOI: 10.1111/acps.12564.
Year 2024, Volume: 14 Issue: 3, 691 - 697, 30.09.2024
https://doi.org/10.33808/clinexphealthsci.1323653

Abstract

References

  • Miller NS, Cocores JA, Belkin B. Schizoaffective disorder: A review. Ann Clin Psychiatry. 2019;31(1):47-53. DOI:10.3109/10401239109147967
  • Malaspina D, Owen MJ, Heckers S, Tandon R, Bustillo J, Schultz S, Barch DM, Gaebel W, Gur RE, Tsuang M, Van Os J, Carpenter W. Schizoaffective disorder in the DSM-5. Schizophr Res. 2013;150(1):21-25. DOI:10.1016/J.SCHRES.2013.04.026
  • Van der Knaap LJ, van der Ham IJM. How does the corpus callosum mediate interhemispheric transfer? A review. Behavioural Brain Research. 2011;223(1):211-221. DOI:10.1016/J.BBR.2011.04.018
  • Frumin M, Golland P, Kikinis R, Hirayasu Y, Salisbury DF, Hennen J, Dickey CC, Anderson M, Jolesz FA, Grimson WE, McCarley RW, Shenton ME. Shape differences in the corpus callosum in first-episode schizophrenia and first-episode psychotic affective disorder. Am J Psychiatry. 2002 May;159(5):866-868. DOI: 10.1176/appi.ajp.159.5.866.
  • Cyprien F, Courtet P, Malafosse A, Maller J, Meslin C, Bonafé A, Le Bars E, de Champfleur NM, Ritchie K, Artero S. Suicidal behavior is associated with reduced corpus callosum area. Biol Psychiatry. 2011 Aug 15;70(4):320-326. DOI: 10.1016/j.biopsych.2011.02.035.
  • Vermeulen CL, du Toit PJ, Venter G, Human-Baron R. A morphological study of the shape of the corpus callosum in normal, schizophrenic and bipolar patients. J Anat. Published online 2022. DOI:10.1111/JOA.13777
  • Styner M, Gerig G, Lieberman J, Jones D, Weinberger D. Statistical shape analysis of neuroanatomical structures based on medial models. Med Image Anal. 2003;7(3):207-220. DOI:10.1016/S1361-8415(02)00110-X
  • Özdemir ST, Ercan I, Sevinc O, Guney I, Ocakoglu G, Aslan E, Barut C. Statistical shape analysis of differences in the shape of the corpus callosum between genders. Anat Rec (Hoboken). 2007 Jul;290(7):825-830. DOI: 10.1002/ar.20558.
  • Türk Y, Ercan I, Sahin I, et al. Corpus callosum in schizophrenia with deficit and non-deficit syndrome: A statistical shape analysis. Gen Psychiatr. 2021;34(6):100635. DOI:10.1136/GPSYCH-2021-10063512.
  • Joshi SH, Narr KL, Philips OR, Nuechterlein KH, Asarnow RF, Toga AW, Woods RP. Statistical shape analysis of the corpus callosum in Schizophrenia. Neuroimage. 2013 Jan 1;64:547-559. DOI: 10.1016/j.neuroimage.2012.09.024.
  • Sarrazin S, d'Albis MA, McDonald C, Linke J, Wessa M, Phillips M, Delavest M, Emsell L, Versace A, Almeida J, Mangin JF, Poupon C, Le Dudal K, Daban C, Hamdani N, Leboyer M, Houenou J. Corpus callosum area in patients with bipolar disorder with and without psychotic features: An international multicentre study. J Psychiatry Neurosci. 2015 Sep;40(5):352-359. DOI: 10.1503/jpn.140262.
  • Sigirli D, Ercan I, Ozdemir ST, Taskapilioglu O, Hakyemez B, Turan OF. Shape analysis of the corpus callosum and cerebellum in female MS patients with different clinical phenotypes. Anat Rec (Hoboken). 2012 Jul;295(7):1202-1211. DOI: 10.1002/ar.22493.
  • Jiang Z, Yang H, Tang X. Deformation-based Statistical Shape Analysis of the Corpus Callosum in Mild Cognitive Impairment and Alzheimer's Disease. Curr Alzheimer Res. 2018;15(12):1151-1160. DOI: 10.2174/1567205015666180813145935.
  • He Q, Duan Y, Miles J, Takahashi N. Statistical shape analysis of the corpus callosum in subtypes of autism. Proceedings of the 7th IEEE International Conference on Bioinformatics and Bioengineering, BIBE. Published online 2007:1087-1091. DOI:10.1109/BIBE.2007.4375694
  • Sigirli D, Gunes A, Turan Ozdemir S, Ercan I, Durmus Y, Erdemli Gursel B. Statistical shape analysis of corpus callosum in restless leg syndrome.2020;42(9):760-766. DOI:10.1080/01616412.2020.1773631
  • Colak C, Ercan I, Dogan M, Ozdemir ST, Sener S, Alkan A. Detecting the shape differences of the corpus callosum in Behçet’s Disease by statistical shape analysis. Anatomical Record. 2011;294(5):870-874. DOI:10.1002/AR.21373
  • American Psychiatric Association and American Psychiatric Association. DSM-5 Task Force., Diagnostic and statistical manual of mental disorders : DSM-5. 5th ed. 2013, Washington, D.C.: American Psychiatric Association. xliv, 947 p.
  • Baykara S, Baykara M, Atmaca M. Statistical shape analysis of corpus callosum in vaginismus. Archives of Psychiatry and Psychotherapy. 2023;25(2):37-44. DOI:10.12740/APP/155218
  • Baykara S, Baykara M, Atmaca M. Regular Islamic prayers have different corpus callosum: A shape analysis study. Egyptian Journal of Neurology, Psychiatry and Neurosurgery. 2023;59(1):1-8. DOI:10.1186/S41983-023-00683-X/FIGURES/4
  • Baykara M, Baykara S, Atmaca M. Statistical shape analysis of corpus callosum in functional neurological disorder. Neuropsychiatria i Neuropsychologia/Neuropsychiatry and Neuropsychology. 2022;17(1):1-8. DOI:10.5114/NAN.2022.117950
  • Zaken V, Kohen R, Ornoy A. Geometric morphometrics of corpus callosum and subcortical structures in the fetal-alcohol-affected brain. Teratology. 2001;64(1):4-32. DOI:10.1002/TERA.1044
  • Ozdemir ST, Ercan I, Sevinc O, Guney I, Ocakoglu G, Aslan E, Barut C. Statistical shape analysis of differences in the shape of the corpus callosum between genders. Anat Rec (Hoboken). 2007 Jul;290(7):825-830. DOI: 10.1002/ar.20558.
  • Rohlf FJ. The tps series of software. Hystrix. 2015;26(1):9-12.
  • Hammer Ø, Harper D, Ryan PD. Past: Paleontological statistics software package for education and data analysis. Palaeontologia Electronica. 2001;4(1):1.
  • Dryden IL, Mardia KV. Statistical Shape Analysis: With Applications in R. John Wiley & Sons; 2016.
  • Team, T.R.C., R. 2021, The R Foundation. p. Free Software Foundation’s GNU General Public License.29.
  • He Q, Duan Y, Karsch K, Miles J. Detecting corpus callosum abnormalities in autism based on anatomical landmarks. Psychiatry Res. 2010 Aug 30;183(2):126-132. DOI: 10.1016/j.pscychresns.2010.05.006. 30.
  • Kaya MO, Ozturk S, Ercan I, Gonen M, Serhat Erol F, Kocabicak E. Statistical shape analysis of subthalamic nucleus in patients with Parkinson Disease. World Neurosurg. 2019 Jun;126:e835-e841. DOI: 10.1016/j.wneu.2019.02.180.
  • Friedrich P, Forkel SJ, Thiebaut de Schotten M. Mapping the principal gradient onto the corpus callosum. Neuroimage. 2020 Dec;223:117317. DOI: 10.1016/j.neuroimage.2020.117317.
  • Fabri M, Polonara G. Functional topography of human corpus callosum: An FMRI mapping study. Neural Plast. 2013;2013:251308. DOI: 10.1155/2013/251308.
  • Chao YP, Cho KH, Yeh CH, Chou KH, Chen JH, Lin CP. Probabilistic topography of human corpus callosum using cytoarchitectural parcellation and high angular resolution diffusion imaging tractography. Hum Brain Mapp. 2009;30(10):3172-3187. DOI:10.1002/HBM.2073935.
  • Hofer S, Frahm J. Topography of the human corpus callosum revisited--comprehensive fiber tractography using diffusion tensor magnetic resonance imaging. Neuroimage. 2006 Sep;32(3):989-994. DOI: 10.1016/j.neuroimage.2006.05.044.
  • He Q, Duan Y, Karsch K, Miles J. Detecting corpus callosum abnormalities in autism based on anatomical landmarks. Psychiatry Res Neuroimaging. 2010;183(2):126-132. DOI:10.1016/j.pscychresns.2010.05.006
  • Francis AN, Mothi SS, Mathew IT, Tandon N, Clementz B, Pearlson GD, Sweeney JA, Tamminga CA, Keshavan MS. Callosal abnormalities across the psychosis dimension: Bipolar schizophrenia network on intermediate phenotypes. Biol Psychiatry. 2016 Oct 15;80(8):627-635. DOI: 10.1016/j.biopsych.2015.12.026.
  • Walterfang M, Wood AG, Reutens DC, Wood SJ, Chen J, Velakoulis D, McGorry PD, Pantelis C. Morphology of the corpus callosum at different stages of schizophrenia: Cross-sectional study in first-episode and chronic illness. Br J Psychiatry. 2008 Jun;192(6):429-34. DOI: 10.1192/bjp.bp.107.041251.
  • Landin-Romero R, Canales-Rodríguez EJ, Kumfor F, Moreno-Alcázar A, Madre M, Maristany T, Pomarol-Clotet E, Amann BL. Surface-based brain morphometry and diffusion tensor imaging in schizoaffective disorder. Aust N Z J Psychiatry. 2017 Jan;51(1):42-54. DOI: 10.1177/0004867416631827.
  • Madre M, Canales-Rodríguez EJ, Ortiz-Gil J, Murru A, Torrent C, Bramon E, Perez V, Orth M, Brambilla P, Vieta E, Amann BL. Neuropsychological and neuroimaging underpinnings of schizoaffective disorder: A systematic review. Acta Psychiatr Scand. 2016 Jul;134(1):16-30. DOI: 10.1111/acps.12564.
There are 37 citations in total.

Details

Primary Language English
Subjects Psychiatry
Journal Section Articles
Authors

Özlem Gül 0000-0003-1236-0348

Sema Baykara 0000-0002-4683-0945

Mustafa Nuray Namlı 0000-0001-9778-4216

Murat Baykara 0000-0003-2588-9013

Early Pub Date September 27, 2024
Publication Date September 30, 2024
Submission Date July 6, 2023
Published in Issue Year 2024 Volume: 14 Issue: 3

Cite

APA Gül, Ö., Baykara, S., Namlı, M. N., Baykara, M. (2024). The Corpus Callosum in Schizoaffective Disorder: A Shape Analysis Study. Clinical and Experimental Health Sciences, 14(3), 691-697. https://doi.org/10.33808/clinexphealthsci.1323653
AMA Gül Ö, Baykara S, Namlı MN, Baykara M. The Corpus Callosum in Schizoaffective Disorder: A Shape Analysis Study. Clinical and Experimental Health Sciences. September 2024;14(3):691-697. doi:10.33808/clinexphealthsci.1323653
Chicago Gül, Özlem, Sema Baykara, Mustafa Nuray Namlı, and Murat Baykara. “The Corpus Callosum in Schizoaffective Disorder: A Shape Analysis Study”. Clinical and Experimental Health Sciences 14, no. 3 (September 2024): 691-97. https://doi.org/10.33808/clinexphealthsci.1323653.
EndNote Gül Ö, Baykara S, Namlı MN, Baykara M (September 1, 2024) The Corpus Callosum in Schizoaffective Disorder: A Shape Analysis Study. Clinical and Experimental Health Sciences 14 3 691–697.
IEEE Ö. Gül, S. Baykara, M. N. Namlı, and M. Baykara, “The Corpus Callosum in Schizoaffective Disorder: A Shape Analysis Study”, Clinical and Experimental Health Sciences, vol. 14, no. 3, pp. 691–697, 2024, doi: 10.33808/clinexphealthsci.1323653.
ISNAD Gül, Özlem et al. “The Corpus Callosum in Schizoaffective Disorder: A Shape Analysis Study”. Clinical and Experimental Health Sciences 14/3 (September 2024), 691-697. https://doi.org/10.33808/clinexphealthsci.1323653.
JAMA Gül Ö, Baykara S, Namlı MN, Baykara M. The Corpus Callosum in Schizoaffective Disorder: A Shape Analysis Study. Clinical and Experimental Health Sciences. 2024;14:691–697.
MLA Gül, Özlem et al. “The Corpus Callosum in Schizoaffective Disorder: A Shape Analysis Study”. Clinical and Experimental Health Sciences, vol. 14, no. 3, 2024, pp. 691-7, doi:10.33808/clinexphealthsci.1323653.
Vancouver Gül Ö, Baykara S, Namlı MN, Baykara M. The Corpus Callosum in Schizoaffective Disorder: A Shape Analysis Study. Clinical and Experimental Health Sciences. 2024;14(3):691-7.

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