1
|
Igg-Dependent Hydrolysis of Myelin Basic Protein of Patients with Different Courses of Schizophrenia. J Immunol Res 2020; 2020:8986521. [PMID: 32851101 PMCID: PMC7439796 DOI: 10.1155/2020/8986521] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 06/04/2020] [Indexed: 02/03/2023] Open
Abstract
The level hydrolysis of myelin basic protein (MBP) by IgG in patients with schizophrenia was studied depending on the clinical features and course of the disease. The patients were grouped according to type of schizophrenia and type of disease course. We found that IgGs isolated and purified from sera of schizophrenia patients' blood hydrolyses human MBP, and the level of this hydrolysis significantly exceeds that of healthy individuals. Detection of protease activity corresponding only to intact IgGs in polyacrylamide gel fragments, together with data of gel filtration of antibodies under conditions of “acid shock” (concordance of optical density profile of IgG with profile of MBP-hydrolyzing activity) and with the absence of any other proteins and bands in gradient SDS-PAGE and in PVDF membrane provides direct evidence that the IgGs from the schizophrenia patients have MBP-hydrolyzing activity. The antibodies-specific proteolytic activity of patients with acute schizophrenia (1.026 [0.205; 3.372] mg MBP/mg IgG/h) significantly exceeds the activity of IgG in patients in remission (0.656 [0.279; 0.873] mg MBP/mg IgG/h) and in healthy individuals (0.000 [0.00; 0.367] mg MBP/mg IgG/h). When comparing the specific activity in patients with different types of disease course, we have found that patients with a continuous course of paranoid schizophrenia (1.810 [0.746; 4.101 mg MBP/mg IgG/h]) had maximal activity values. It can be assumed that the increase in the activity of MBP-hydrolyzing antibodies is due to the activation of humoral immunity in acute schizophrenia.
Collapse
|
2
|
Mana S, Paillère Martinot ML, Martinot JL. Brain imaging findings in children and adolescents with mental disorders: A cross-sectional review. Eur Psychiatry 2020; 25:345-54. [PMID: 20620025 DOI: 10.1016/j.eurpsy.2010.04.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2010] [Revised: 04/08/2010] [Accepted: 04/22/2010] [Indexed: 01/18/2023] Open
Abstract
AbstractBackgroundWhile brain imaging studies of juvenile patients has expanded in recent years to investigate the cerebral neurophysiologic correlates of psychiatric disorders, this research field remains scarce. The aim of the present review was to cluster the main mental disorders according to the differential brain location of the imaging findings recently reported in children and adolescents reports. A second objective was to describe the worldwide distribution and the main directions of the recent magnetic resonance imaging (MRI) and positron tomography (PET) studies in these patients.MethodsA survey of 423 MRI and PET articles published between 2005 and 2008 was performed. A principal component analysis (PCA), then an activation likelihood estimate (ALE) meta-analysis, were applied on brain regional information retrieved from articles in order to cluster the various disorders with respect to the cerebral structures where alterations were reported. Furthermore, descriptive analysis characterized the literature production.ResultsTwo hundred and seventy-four articles involving children and adolescent patients were analyzed. Both the PCA and ALE methods clustered, three groups of diagnosed psychiatric disorders, according to the brain structural and functional locations: one group of affective disorders characterized by abnormalities of the frontal-limbic regions; a group of mental disorders with “cognition deficits” mainly related to cortex abnormalities; and one psychomotor condition associated with abnormalities in the basal ganglia. The descriptive analysis indicates a focus on attention deficit hyperactivity disorders and autism spectrum disorders, a general steady rise in the number of annual reports, and lead of US research.ConclusionThis cross-sectional review of child and adolescent mental disorders based on neuroimaging findings suggests overlaps of brain locations that allow to cluster the diagnosed disorders into three sets with respectively marked affective, cognitive, and psychomotor phenomenology. Furthermore, the brain imaging research effort was unequally distributed across disorders, and did not reflect their prevalence.
Collapse
Affiliation(s)
- S Mana
- Service hospitalier central de médecine nucléaire et neurospin, INSERM-CEA, Research Unit 1000 Neuroimaging & psychiatry, University Paris Sud and University Paris Descartes, 4, place Gl.-Leclerc, 91401 Orsay, France.
| | | | | |
Collapse
|
3
|
Liu Y, Guo W, Zhang Y, Lv L, Hu F, Wu R, Zhao J. Decreased Resting-State Interhemispheric Functional Connectivity Correlated with Neurocognitive Deficits in Drug-Naive First-Episode Adolescent-Onset Schizophrenia. Int J Neuropsychopharmacol 2017; 21:33-41. [PMID: 29228204 PMCID: PMC5795351 DOI: 10.1093/ijnp/pyx095] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 10/19/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Given that adolescence is a critical epoch in the onset of schizophrenia, studying aberrant brain changes in adolescent-onset schizophrenia, particularly in patients with drug-naive first-episode schizophrenia, is important to understand the biological mechanism of this disorder. Previous resting-state functional magnetic resonance imaging studies have shown abnormal functional connectivity in separate hemispheres in patients with adult-onset schizophrenia. Our aim to study adolescent-onset schizophrenia can provide clues for the early aetiology of schizophrenia. METHOD A total of 48 drug-naïve, first-episode, adolescent-onset schizophrenia outpatients and 31 healthy controls underwent resting-state functional magnetic resonance imaging scans. Data were subjected to voxel-mirrored homotopic connectivity and support vector machine analyses. RESULTS Compared with the healthy controls, the adolescent-onset schizophrenia group showed significantly lower voxel-mirrored homotopic connectivity values in different brain regions, including the fusiform gyrus, superior temporal gyrus/insula, precentral gyrus, and precuneus. Decreased voxel-mirrored homotopic connectivity values in the superior temporal gyrus/insula were significantly correlated with Trail-Making Test: Part A performance (r = -0.437, P = .002). A combination of the voxel-mirrored homotopic connectivity values in the precentral gyrus and precuneus may be used to discriminate patients with adolescent-onset schizophrenia from controls with satisfactory classification results, which showed sensitivity of 100%, specificity of 87.09%, and accuracy of 94.93%. CONCLUSION Our findings highlight resting-state interhemispheric FC abnormalities within the sensorimotor network of patients with adolescent-onset schizophrenia and confirm the relationship between adolescent-onset schizophrenia and adult-onset schizophrenia. These findings suggest that reduced interhemispheric connectivity within the sensorimotor network has a pivotal role in the pathogenesis of schizophrenia.
Collapse
Affiliation(s)
- Yi Liu
- Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, Hunan,Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan, China,National Clinical Research Center on Mental Disorders, Changsha, Hunan, China,National Technology Institute on Mental Disorders, Changsha, Hunan, China,Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, China
| | - Wenbin Guo
- Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, Hunan,Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan, China,National Clinical Research Center on Mental Disorders, Changsha, Hunan, China,National Technology Institute on Mental Disorders, Changsha, Hunan, China,Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, China
| | - Yan Zhang
- Henan Key Laboratory of Biological Psychiatry, Henan Mental Hospital, Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Luxian Lv
- Henan Key Laboratory of Biological Psychiatry, Henan Mental Hospital, Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Feihu Hu
- Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, Hunan,Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan, China,National Clinical Research Center on Mental Disorders, Changsha, Hunan, China,National Technology Institute on Mental Disorders, Changsha, Hunan, China,Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, China
| | - Renrong Wu
- Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, Hunan,Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan, China,National Clinical Research Center on Mental Disorders, Changsha, Hunan, China,National Technology Institute on Mental Disorders, Changsha, Hunan, China,Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, China
| | - Jingping Zhao
- Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, Hunan,Henan Key Laboratory of Biological Psychiatry, Henan Mental Hospital, Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China,Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan, China,National Clinical Research Center on Mental Disorders, Changsha, Hunan, China,National Technology Institute on Mental Disorders, Changsha, Hunan, China,Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, China,Correspondence: Jingping Zhao, MD, Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China ()
| |
Collapse
|
4
|
Fraguas D, Díaz-Caneja CM, Pina-Camacho L, Janssen J, Arango C. Progressive brain changes in children and adolescents with early-onset psychosis: A meta-analysis of longitudinal MRI studies. Schizophr Res 2016; 173:132-139. [PMID: 25556081 DOI: 10.1016/j.schres.2014.12.022] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Revised: 12/11/2014] [Accepted: 12/15/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND Studies on longitudinal brain volume changes in patients with early-onset psychosis (EOP) are particularly valuable for understanding the neurobiological basis of brain abnormalities associated with psychosis. However, findings have not been consistent across studies in this population. We aimed to conduct a meta-analysis on progressive brain volume changes in children and adolescents with EOP. METHODS A systematic literature search of magnetic resonance imaging (MRI) studies comparing longitudinal brain volume changes in children and adolescents with EOP and healthy controls was conducted. The annualized rates of relative change in brain volume by region of interest (ROI) were used as raw data for the meta-analysis. The effect of age, sex, duration of illness, and specific diagnosis on volume change was also evaluated. RESULTS Five original studies with 156 EOP patients (mean age at baseline MRI in the five studies ranged from 13.3 to 16.6years, 67.31% males) and 163 age- and sex-matched healthy controls, with a mean duration of follow-up of 2.46years (range 2.02-3.40), were included. Frontal gray matter (GM) was the only region in which significant differences in volume change over time were found between patients and controls (Hedges' g -0.435, 95% confidence interval (CI): -0.678 to -0.193, p<0.001). Younger age at baseline MRI was associated with greater loss of temporal GM volume over time in patients as compared with controls (p=0.005). Within patients, a diagnosis of schizophrenia was related to greater occipital GM volume loss over time (p=0.001). CONCLUSIONS Compared with healthy individuals, EOP patients show greater progressive frontal GM loss over the first few years after illness onset. Age at baseline MRI and diagnosis of schizophrenia appear to be significant moderators of particular specific brain volume changes.
Collapse
Affiliation(s)
- David Fraguas
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, CIBERSAM, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), School of Medicine, Universidad Complutense, Madrid, Spain
| | - Covadonga M Díaz-Caneja
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, CIBERSAM, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), School of Medicine, Universidad Complutense, Madrid, Spain
| | - Laura Pina-Camacho
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, CIBERSAM, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), School of Medicine, Universidad Complutense, Madrid, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College London, London, UK
| | - Joost Janssen
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, CIBERSAM, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), School of Medicine, Universidad Complutense, Madrid, Spain; Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, The Netherlands
| | - Celso Arango
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, CIBERSAM, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), School of Medicine, Universidad Complutense, Madrid, Spain.
| |
Collapse
|
5
|
Zhang Y, Zheng J, Fan X, Guo X, Guo W, Yang G, Chen H, Zhao J, Lv L. Dysfunctional resting-state connectivities of brain regions with structural deficits in drug-naive first-episode schizophrenia adolescents. Schizophr Res 2015; 168:353-9. [PMID: 26281967 DOI: 10.1016/j.schres.2015.07.031] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 07/05/2015] [Accepted: 07/17/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Individuals with adolescent-onset schizophrenia (AOS) are a subgroup of patients who present clinical symptoms between 13 and 18years of age. Little is known about neurodevelopmental abnormalities in this patient population. The present study was to examine possible resting-state dysfunctional connectivity of brain regions with altered gray matter volume in AOS. METHODS Gray matter volume was investigated by voxel-based morphometry (VBM) analysis. Resting-state functional connectivity analysis was used to examine the correlations between regions with structural deficits and the remaining regions. RESULTS Thirty-seven first-episode schizophrenia adolescents and 30 healthy controls were enrolled. Compared to the controls, the patients showed significantly decreased gray matter volumes in the right superior temporal gyrus (STG) and middle temporal gyrus (MTG) (ps<0.05). With the right STG as seed, significantly reduced connectivities were found within the frontal-temporal networks in the patient group (ps<0.05). With the right MTG as seed, the patient group showed significantly reduced connectivities in the default-mode networks and visual networks (ps<0.05). Compared to significant correlations in the controls (p=0.02), the patients had no observed correlations between functional connectivity of the right STG and gray matter volume of this region. Significant positive correlations were found between functional connectivity of the right STG with the left middle frontal gyrus and the Positive and Negative Syndrome Scale total scores (p=0.048) after controlling the confounding variables. CONCLUSIONS These findings show dysfunctional resting-state connectivities of the right STG and MTG with decreased gray matter volume in adolescents with AOS, suggesting that neurodevelopmental abnormalities may be present in AOS.
Collapse
Affiliation(s)
- Yan Zhang
- Mental Health Institute, The Second Xiangya Hospital of Central South University, Key Laboratory for Mental Health of Hunan Province, Changsha, China; Department of Psychiatry, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Junjie Zheng
- Key Laboratory for NeuroInformation of the Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Xiaoduo Fan
- UMass Memorial Medical Center, University of Massachusetts Medical School, MA, USA
| | - Xiaofeng Guo
- Mental Health Institute, The Second Xiangya Hospital of Central South University, Key Laboratory for Mental Health of Hunan Province, Changsha, China
| | - Wenbin Guo
- Mental Health Institute, The Second Xiangya Hospital of Central South University, Key Laboratory for Mental Health of Hunan Province, Changsha, China
| | - Ge Yang
- Department of Psychiatry, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Huafu Chen
- Key Laboratory for NeuroInformation of the Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Jingping Zhao
- Mental Health Institute, The Second Xiangya Hospital of Central South University, Key Laboratory for Mental Health of Hunan Province, Changsha, China.
| | - Luxian Lv
- Department of Psychiatry, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China.
| |
Collapse
|
6
|
Hirnstein M, Hugdahl K. Excess of non-right-handedness in schizophrenia: meta-analysis of gender effects and potential biases in handedness assessment. Br J Psychiatry 2014; 205:260-7. [PMID: 25274314 DOI: 10.1192/bjp.bp.113.137349] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND The notion that schizophrenia is characterised by increased non-right-handedness is a cornerstone of the theory that schizophrenia arises from, and is genetically linked to, abnormal brain lateralisation. Reviews and meta-analyses have reported higher rates of non-right-handers in patients with schizophrenia. However, this was suggested to be the result of a gender artefact or a hidden bias in self-report handedness questionnaires. AIMS To investigate using a meta-analytical approach whether the excess of non-right-handedness is seen in both females and males, and also when handedness is assessed behaviourally. METHOD Electronic databases were searched for studies that reported (a) the rate of female and male non-right-handers in schizophrenia compared with controls and (b) the rate of non-right-handers in schizophrenia (regardless of gender) based on behavioural handedness assessment. RESULTS The odds ratios (ORs) for females (OR = 1.63; based on 621 patients, 3747 controls) and males (OR = 1.50; based on 1213 patients, 3800 controls) differed significantly from 1.0, indicating both female and male patients were more often non-right-handed than controls. Moreover, there was an excess of non-right-handedness in patients with schizophrenia when handedness was assessed behaviourally: OR = 1.84 (1255 patients, 6260 controls). Even when both gender and behavioural handedness assessment were controlled for simultaneously, the excess of non-right-handedness persisted. CONCLUSIONS The findings clearly demonstrate that the excess of non-right-handedness in schizophrenia does not result from a gender artefact or from biased handedness questionnaires. It is a true empirical effect and may indeed reflect a genetic link between schizophrenia and brain lateralisation.
Collapse
Affiliation(s)
- Marco Hirnstein
- Marco Hirnstein, PhD, Department of Biological and Medical Psychology, University of Bergen; Kenneth Hugdahl, PhD, Department of Biological and Medical Psychology, University of Bergen, and Division of Psychiatry and Department of Radiology, Haukeland University Hospital, Bergen, Norway
| | - Kenneth Hugdahl
- Marco Hirnstein, PhD, Department of Biological and Medical Psychology, University of Bergen; Kenneth Hugdahl, PhD, Department of Biological and Medical Psychology, University of Bergen, and Division of Psychiatry and Department of Radiology, Haukeland University Hospital, Bergen, Norway
| |
Collapse
|
7
|
Janssen J, Alemán-Gómez Y, Schnack H, Balaban E, Pina-Camacho L, Alfaro-Almagro F, Castro-Fornieles J, Otero S, Baeza I, Moreno D, Bargalló N, Parellada M, Arango C, Desco M. Cortical morphology of adolescents with bipolar disorder and with schizophrenia. Schizophr Res 2014; 158:91-9. [PMID: 25085384 DOI: 10.1016/j.schres.2014.06.040] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Revised: 05/12/2014] [Accepted: 06/24/2014] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Recent evidence points to overlapping decreases in cortical thickness and gyrification in the frontal lobe of patients with adult-onset schizophrenia and bipolar disorder with psychotic symptoms, but it is not clear if these findings generalize to patients with a disease onset during adolescence and what may be the mechanisms underlying a decrease in gyrification. METHOD This study analyzed cortical morphology using surface-based morphometry in 92 subjects (age range 11-18 years, 52 healthy controls and 40 adolescents with early-onset first-episode psychosis diagnosed with schizophrenia (n=20) or bipolar disorder with psychotic symptoms (n=20) based on a two year clinical follow up). Average lobar cortical thickness, surface area, gyrification index (GI) and sulcal width were compared between groups, and the relationship between the GI and sulcal width was assessed in the patient group. RESULTS Both patients groups showed decreased cortical thickness and increased sulcal width in the frontal cortex when compared to healthy controls. The schizophrenia subgroup also had increased sulcal width in all other lobes. In the frontal cortex of the combined patient group sulcal width was negatively correlated (r=-0.58, p<0.001) with the GI. CONCLUSIONS In adolescents with schizophrenia and bipolar disorder with psychotic symptoms there is cortical thinning, decreased GI and increased sulcal width of the frontal cortex present at the time of the first psychotic episode. Decreased frontal GI is associated with the widening of the frontal sulci which may reduce sulcal surface area. These results suggest that abnormal growth (or more pronounced shrinkage during adolescence) of the frontal cortex represents a shared endophenotype for psychosis.
Collapse
Affiliation(s)
- Joost Janssen
- Instituto de Investigación Sanitaria Gregorio Marañón, Dr. Esquerdo, 46, 28007 Madrid, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Dr. Esquerdo, 46, 28007 Madrid, Spain; Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Dr. Esquerdo, 46, 28007 Madrid, Spain; Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
| | - Yasser Alemán-Gómez
- Instituto de Investigación Sanitaria Gregorio Marañón, Dr. Esquerdo, 46, 28007 Madrid, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Dr. Esquerdo, 46, 28007 Madrid, Spain; Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Avda. de la Universidad, 30, 28911 Leganés, Madrid, Spain
| | - Hugo Schnack
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Evan Balaban
- Behavioral Neurosciences Program, McGill University, N8-15 Stewart Biological Sciences Building, 1205 Docteur Penfield Avenue, Montreal QC H3A 1B1, Canada
| | - Laura Pina-Camacho
- Instituto de Investigación Sanitaria Gregorio Marañón, Dr. Esquerdo, 46, 28007 Madrid, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Dr. Esquerdo, 46, 28007 Madrid, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College London, 16 de Crespigny Park, London SE5 8AF, UK
| | - Fidel Alfaro-Almagro
- Instituto de Investigación Sanitaria Gregorio Marañón, Dr. Esquerdo, 46, 28007 Madrid, Spain
| | - Josefina Castro-Fornieles
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Dr. Esquerdo, 46, 28007 Madrid, Spain; Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic of Neurosciences, Hospital Clínic Universitari of Barcelona, Villarroel, 170, Barcelona 08036, Spain; Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Casanovas, 143, Barcelona 08036, Spain
| | - Soraya Otero
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Dr. Esquerdo, 46, 28007 Madrid, Spain; Child and Adolescent Mental Health Unit, Department of Psychiatry and Psychology, Hospital Universitario Marqués de Valdecilla, Avda. Valdecilla nº 25, 39008 Santander, Spain
| | - Inmaculada Baeza
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Dr. Esquerdo, 46, 28007 Madrid, Spain; Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic of Neurosciences, Hospital Clínic Universitari of Barcelona, Villarroel, 170, Barcelona 08036, Spain
| | - Dolores Moreno
- Instituto de Investigación Sanitaria Gregorio Marañón, Dr. Esquerdo, 46, 28007 Madrid, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Dr. Esquerdo, 46, 28007 Madrid, Spain; Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Dr. Esquerdo, 46, 28007 Madrid, Spain
| | - Nuria Bargalló
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Dr. Esquerdo, 46, 28007 Madrid, Spain; Magnetic Resonance Image Core Facility, IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), Barcelona, Spain; Image Diagnostic Center, Hospital Clínic, Barcelona, Spain
| | - Mara Parellada
- Instituto de Investigación Sanitaria Gregorio Marañón, Dr. Esquerdo, 46, 28007 Madrid, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Dr. Esquerdo, 46, 28007 Madrid, Spain; Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Dr. Esquerdo, 46, 28007 Madrid, Spain
| | - Celso Arango
- Instituto de Investigación Sanitaria Gregorio Marañón, Dr. Esquerdo, 46, 28007 Madrid, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Dr. Esquerdo, 46, 28007 Madrid, Spain; Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Dr. Esquerdo, 46, 28007 Madrid, Spain
| | - Manuel Desco
- Instituto de Investigación Sanitaria Gregorio Marañón, Dr. Esquerdo, 46, 28007 Madrid, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Dr. Esquerdo, 46, 28007 Madrid, Spain; Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Avda. de la Universidad, 30, 28911 Leganés, Madrid, Spain
| |
Collapse
|
8
|
Age-related cortical thickness differences in adolescents with early-onset schizophrenia compared with healthy adolescents. Psychiatry Res 2013; 214:190-6. [PMID: 24144503 DOI: 10.1016/j.pscychresns.2013.07.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2013] [Revised: 05/12/2013] [Accepted: 07/09/2013] [Indexed: 11/21/2022]
Abstract
The aim of the present study was to investigate the influence of age on cerebral cortical thickness in adolescents with early-onset schizophrenia (EOS) (n=22, aged 12-18 years), as compared to an age-matched healthy control group (n=32). All participants were scanned with magnetic resonance imaging. Whereas in the healthy control group there was a negative association between increasing age and cortical thickness measures in widespread brain regions, including frontal and parietal cortices, the patient group showed no significant effects of age when the groups were studied separately. There was a trend towards an age-by-group effect in the left supramarginal gyrus and the right pre- and postcentral gyri. The between-group statistical analysis indicated similar cortical thickness in the patients as in the healthy controls. There were no significant effects of medication on cortical thickness, nor was there any significant sex-by-group interaction. The results suggest that patients with EOS have a deficiency of the expected cortical thinning to occur during adolescence development. The findings are discussed in context of neurobiological processes known to be involved in brain maturation, including synaptic reorganization, pruning and myelination.
Collapse
|
9
|
Schwerk A, Alves FDS, Pouwels PJW, van Amelsvoort T. Metabolic alterations associated with schizophrenia: a critical evaluation of proton magnetic resonance spectroscopy studies. J Neurochem 2013; 128:1-87. [DOI: 10.1111/jnc.12398] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2013] [Revised: 07/31/2013] [Accepted: 08/03/2013] [Indexed: 12/19/2022]
Affiliation(s)
- Anne Schwerk
- Department of Neurology; Charité - University Medicine; Berlin Germany
| | - Fabiana D. S. Alves
- Department of Psychiatry; Academic Medical Centre; Amsterdam The Netherlands
| | - Petra J. W. Pouwels
- Department of Physics& Medical Technology; VU University Medical Centre; Amsterdam The Netherlands
| | - Therese van Amelsvoort
- Department of Psychiatry and Psychology; Maastricht University; Maastricht The Netherlands
| |
Collapse
|
10
|
Juuhl-Langseth M, Rimol LM, Rasmussen IA, Thormodsen R, Holmén A, Emblem KE, Due-Tønnessen P, Rund BR, Agartz I. Comprehensive segmentation of subcortical brain volumes in early onset schizophrenia reveals limited structural abnormalities. Psychiatry Res 2012; 203:14-23. [PMID: 22917502 DOI: 10.1016/j.pscychresns.2011.10.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2011] [Revised: 09/09/2011] [Accepted: 10/18/2011] [Indexed: 11/20/2022]
Abstract
Structural brain abnormalities are well documented in adult schizophrenia, but there are few studies of brain structures in early onset schizophrenia (EOS) and findings are inconsistent. Most previous EOS studies have been limited to global morphometric measures, such as whole gray matter (GM) or cerebrospinal fluid (CSF), or to single brain structures. The purpose of this study was to compare specific volumes and hemispheric lateralization in a large number of subcortical brain structures, between EOS patients and a healthy control group. High-resolution structural magnetic resonance images (MRI) and automatic brain volume segmentation were performed on 18 EOS patients and 33 healthy controls (11-18 years). A total of 29 brain structures were studied. The patients showed marked bilateral enlargements of the lateral ventricles and of the fourth ventricle, and bilateral enlargement of the caudate nuclei compared to the controls. For all other subcortical brain structures, there were no significant differences between the EOS group and the healthy control group, contrary to findings from the majority of morphometric studies of childhood or adult onset schizophrenia.
Collapse
Affiliation(s)
- Monica Juuhl-Langseth
- Research Unit for Child and Adolescent Mental Health, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
| | | | | | | | | | | | | | | | | |
Collapse
|
11
|
Reig S, Parellada M, Castro-Fornieles J, Janssen J, Moreno D, Baeza I, Bargalló N, González-Pinto A, Graell M, Ortuño F, Otero S, Arango C, Desco M. Multicenter study of brain volume abnormalities in children and adolescent-onset psychosis. Schizophr Bull 2011; 37:1270-80. [PMID: 20478821 PMCID: PMC3196940 DOI: 10.1093/schbul/sbq044] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The goal of the study is to determine the extent of structural brain abnormalities in a multicenter sample of children and adolescents with a recent-onset first episode of psychosis (FEP), compared with a sample of healthy controls. Total brain and lobar volumes and those of gray matter (GM), white matter, and cerebrospinal fluid (CSF) were measured in 92 patients with a FEP and in 94 controls, matched for age, gender, and years of education. Male patients (n = 64) showed several significant differences when compared with controls (n = 61). GM volume in male patients was reduced in the whole brain and in frontal and parietal lobes compared with controls. Total CSF volume and frontal, temporal, and right parietal CSF volumes were also increased in male patients. Within patients, those with a further diagnosis of "schizophrenia" or "other psychosis" showed a pattern similar to the group of all patients relative to controls. However, bipolar patients showed fewer differences relative to controls. In female patients, only the schizophrenia group showed differences relative to controls, in frontal CSF. GM deficit in male patients with a first episode correlated with negative symptoms. Our study suggests that at least part of the GM deficit in children and adolescent-onset schizophrenia and in other psychosis occurs before onset of the first positive symptoms and that, contrary to what has been shown in children-onset schizophrenia, frontal GM deficits are probably present from the first appearance of positive symptoms in children and adolescents.
Collapse
Affiliation(s)
- Santiago Reig
- Unidad de Medicina y Cirugía Experimental, Hospital General Universitario Gregorio Marañón, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain,To whom correspondence should be addressed; tel: +34-91-586-6678, fax: +34-91-426-5108; e-mail:
| | - Mara Parellada
- Unidad de Adolescentes, Departamento de Psiquiatría, Hospital General Universitario Gregorio Marañón, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Josefina Castro-Fornieles
- Servicio de Psiquiatría y Psicología Infantil y Juvenil, Universidad de Barcelona, IDIBAPS (Institut d'Investigacions Biomèdiques August Pi I Sunyer), Hospital Clínic Universitari de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Barcelona, Spain
| | - Joost Janssen
- Unidad de Medicina y Cirugía Experimental, Hospital General Universitario Gregorio Marañón, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Dolores Moreno
- Unidad de Adolescentes, Departamento de Psiquiatría, Hospital General Universitario Gregorio Marañón, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Inmaculada Baeza
- Servicio de Psiquiatría y Psicología Infantil y Juvenil, Institut de Neurociències, Hospital Clínic i Universitari, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Barcelona, Spain
| | - Nuria Bargalló
- Departamento de Radiología, Centro de Diagnóstico por la Imagen, Hospital Clínico, Barcelona, Spain
| | - Ana González-Pinto
- Stanley Institute International Mood-Disorders Research Center, 03-RC-003, Hospital Santiago Apóstol, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Vitoria, Spain
| | - Montserrat Graell
- Servicio de Psiquiatría y Psicología Infantil y Juvenil, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Felipe Ortuño
- Departamento de Psiquiatría y Psicología Médica, Clínica Universitaria de Navarra, Pamplona, Navarra, Spain
| | - Soraya Otero
- Servicio de Psiquiatría y Psicología Infantil y Juvenil, Departamento de Psiquiatría, Hospital Universitario Marqués de Valdecilla, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Santander, Cantabria, Spain
| | - Celso Arango
- Unidad de Adolescentes, Departamento de Psiquiatría, Hospital General Universitario Gregorio Marañón, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Manuel Desco
- Unidad de Medicina y Cirugía Experimental, Hospital General Universitario Gregorio Marañón, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| |
Collapse
|
12
|
Parellada M, Boada L, Fraguas D, Reig S, Castro-Fornieles J, Moreno D, Gonzalez-Pinto A, Otero S, Rapado-Castro M, Graell M, Baeza I, Arango C. Trait and state attributes of insight in first episodes of early-onset schizophrenia and other psychoses: a 2-year longitudinal study. Schizophr Bull 2011; 37:38-51. [PMID: 20884756 PMCID: PMC3004178 DOI: 10.1093/schbul/sbq109] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Increasing evidence supports the important role of illness state and individual characteristics in insight. METHODS Insight, as measured with the Scale to Assess Unawareness of Mental Disorder, over the first 2 years of early-onset first-episode psychosis and its correlations with clinical, socio-demographic, cognitive, and structural brain variables are studied. RESULTS (1) insight at 2 years is poorer in schizophrenia spectrum disorders (SSDs) than in subjects with other psychoses; (2) the more severe the psychosis, the worse the insight. In SSD, depressive symptoms, poorer baseline executive functioning, lower IQ, longer duration of untreated psychosis (DUP), and poorer premorbid infancy adjustment are associated with poorer insight; frontal and parietal gray matter (GM) reductions at baseline correlate with worse insight into having psychotic symptoms at 2 years; (3) insight into having a mental disorder (Scale to Assess Unawareness of Mental Disorder [SUMD]1) at 1 year, DUP, and baseline IQ are the most consistent variables explaining different aspects of insight at 2 years in SSD patients. IQ and SUMD1 at 1 year, together with left frontal and parietal GM volumes, explain 80% of the variance of insight into having specific psychotic symptoms in SSD patients (adjusted R(2) = 0.795, F = 15.576, P < .001). CONCLUSION Insight is a complex phenomenon that depends both on severity of psychopathology and also on disease and subject characteristics, such as past adjustment, IQ, DUP, cognitive functioning, frontal and parietal GM volumes, and age, gender, and ethnicity.
Collapse
Affiliation(s)
- Mara Parellada
- Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Ibiza 43, Madrid 28009, Spain.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Abstract
BACKGROUND People with schizophrenia are often found to have smaller brains and larger brain ventricles than normal, but the role of antipsychotic medication remains unclear. METHOD We conducted a systematic review of magnetic resonance imaging (MRI) studies. We included longitudinal studies of brain changes in patients taking antipsychotic drugs and we examined studies of antipsychotic-naive patients for comparison purposes. RESULTS Fourteen out of 26 longitudinal studies showed a decline in global brain or grey-matter volume or an increase in ventricular or cerebrospinal fluid (CSF) volume during the course of drug treatment, including the largest studies conducted. The frontal lobe was most consistently affected, but overall changes were diffuse. One large study found different degrees of volume loss with different antipsychotics, and another found that volume changes were associated with taking medication compared with taking none. Analyses of linear associations between drug exposure and brain volume changes produced mixed results. Five out of 21 studies of patients who were drug naive, or had only minimal prior treatment, showed some differences from controls in volumes of interest. No global differences were reported in three studies of drug-naive patients with long-term illness. Studies of high-risk groups have not demonstrated differences from controls in global or lobar brain volumes. CONCLUSIONS Some evidence points towards the possibility that antipsychotic drugs reduce the volume of brain matter and increase ventricular or fluid volume. Antipsychotics may contribute to the genesis of some of the abnormalities usually attributed to schizophrenia.
Collapse
Affiliation(s)
- J Moncrieff
- Department of Mental Health Sciences, University College London, UK.
| | | |
Collapse
|
14
|
El-Sayed M, Steen RG, Poe MD, Bethea TC, Gerig G, Lieberman J, Sikich L. Brain volumes in psychotic youth with schizophrenia and mood disorders. J Psychiatry Neurosci 2010; 35:229-36. [PMID: 20569649 PMCID: PMC2895153 DOI: 10.1503/jpn.090051] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND We sought to test the hypothesis that deficits in grey matter volume are characteristic of psychotic youth with early-onset schizophrenia-spectrum disorders (EOSS) but not of psychotic youth with early-onset mood disorders (EOMD). METHODS We used magnetic resonance imaging to examine brain volume in 24 psychotic youth (13 male, 11 female) with EOSS (n = 12) or EOMD (n = 12) and 17 healthy controls (10 male, 7 female). We measured the volume of grey and white matter using an automated segmentation program. RESULTS After adjustment for age and intracranial volume, whole brain volume was lower in the EOSS patients than in the healthy controls (p = 0.001) and EOMD patients (p = 0.002). The EOSS patients had a deficit in grey matter volume (p = 0.005), especially in the frontal (p = 0.003) and parietal (p = 0.006) lobes, with no significant differences in white matter volume. LIMITATIONS The main limitations of our study were its small sample size and the inclusion of patients with depression and mania in the affective group. CONCLUSION Adolescents with EOSS have grey matter deficits compared with healthy controls and psychotic adolescents with EOMD. Our results suggest that grey matter deficits are not generally associated with psychosis but may be specifically associated with schizophrenia. Larger studies with consistent methods are needed to reconcile the contradictory findings among imaging studies involving psychotic youth.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Linmarie Sikich
- Correspondence to: Dr. L. Sikich, Department of Psychiatry, University of North Carolina, Chapel Hill NC 27599-7160; fax 919 966-9646;
| |
Collapse
|
15
|
Mattai A, Chavez A, Greenstein D, Clasen L, Bakalar J, Stidd R, Rapoport J, Gogtay N. Effects of clozapine and olanzapine on cortical thickness in childhood-onset schizophrenia. Schizophr Res 2010; 116:44-8. [PMID: 19913390 PMCID: PMC2795130 DOI: 10.1016/j.schres.2009.10.018] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2009] [Revised: 10/19/2009] [Accepted: 10/19/2009] [Indexed: 11/16/2022]
Abstract
BACKGROUND Little is known about the effects of antipsychotic medications on gray matter (GM) in schizophrenia. Although clozapine remains the most effective antipsychotic medication in treatment-refractory cases, it is unknown whether it has a differential effect on GM development. METHODS In an exploratory analysis, we used automated cortical thickness measurements and prospectively scanned childhood-onset schizophrenia (COS) patients who were maintained on one medication. Two atypical antipsychotic medications, clozapine (n=12, 37 scans) and olanzapine (n=12, 33 scans) were compared with respect to effects on cortical development, in contrast to GM trajectories of matched controls. RESULTS There were no significant differences in the trajectories of cortical thickness between the two treatment groups with the exception of a small circumscribed area in the right prefrontal cortex, where the olanzapine group showed thicker cortex. As expected, both groups showed thinner GM compared to matched controls. CONCLUSIONS Although these analyses do not rule out effects of antipsychotic medications on GM development in schizophrenia, they show no differential effect between clozapine and olanzapine on GM trajectory.
Collapse
Affiliation(s)
- Anand Mattai
- Child Psychiatry Branch, NIMH, NIH, Bethesda, MD, 20892-1600, United States.
| | | | | | | | | | | | | | | |
Collapse
|
16
|
Tayoshi S, Sumitani S, Taniguchi K, Shibuya-Tayoshi S, Numata S, Iga JI, Nakataki M, Ueno SI, Harada M, Ohmori T. Metabolite changes and gender differences in schizophrenia using 3-Tesla proton magnetic resonance spectroscopy (1H-MRS). Schizophr Res 2009; 108:69-77. [PMID: 19097753 DOI: 10.1016/j.schres.2008.11.014] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2008] [Revised: 11/10/2008] [Accepted: 11/10/2008] [Indexed: 10/21/2022]
Abstract
A change in the glutamatergic system is thought to play an important role in the pathophysiology of schizophrenia. The aim of this study was to investigate the changes in metabolites, including glutamate (Glu), in the anterior cingulate cortex (ACC) and the left basal ganglia (ltBG) of patients with chronic schizophrenia using proton magnetic resonance spectroscopy ((1)H-MRS). In addition, since gender differences in this illness were known, we examined the effects of gender on these metabolites. The (1)H-MRS was performed on the ACC and ltBG of 30 patients with schizophrenia and 25 healthy individuals who acted as the control group. The levels of Glu, glutamine (Gln), creatine plus phosphocreatine (Cre), myo-inositol (mI), N-acetylaspartate (NAA), and choline-containing compounds (Cho) were measured. Two-way analysis of variance revealed that the illness significantly affected the levels of Glu and mI in the ACC; both metabolites were lower in the patients with schizophrenia as compared to the control subjects. The results also revealed that gender significantly affected the level of Gln in the ACC and the levels of Cre and NAA in the ltBG; the level of Gln in the ACC were higher in male subjects versus female subjects, whereas Cre and NAA levels in the ltBG were lower in male subjects as compared to female subjects. These results confirmed a change in the glutamatergic system and suggested an involvement of mI in the pathophysiology of schizophrenia.
Collapse
Affiliation(s)
- Shin'Ya Tayoshi
- Department of Psychiatry, Course of Integrated Brain Sciences, Medical Informatics, Institute of Health Biosciences, University of Tokushima Graduate School, Japan.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Reig S, Moreno C, Moreno D, Burdalo M, Janssen J, Parellada M, Zabala A, Desco M, Arango C. Progression of brain volume changes in adolescent-onset psychosis. Schizophr Bull 2009; 35:233-43. [PMID: 18222929 PMCID: PMC2643965 DOI: 10.1093/schbul/sbm160] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Little is known about the changes that take place in the adolescent brain over the first few years following the onset of psychosis. The present longitudinal study builds on an earlier cross-sectional report demonstrating brain abnormalities in adolescent-onset psychosis patients with a recent-onset first episode of psychosis. Magnetic resonance imaging studies were obtained at baseline and 2 years later from 21 adolescents with psychosis and 34 healthy controls matched for age, gender, and years of education. Whole-brain volumes and gray matter (GM) and cerebrospinal fluid (CSF) volumes of the frontal, parietal, temporal, and occipital lobes were measured at baseline and at 2-year follow-up. In the frontal lobe, the rate of GM volume loss was significantly higher in male patients (2.9% and 2.0%, respectively, for left and right) than in controls (1.2% and 0.7%, respectively, for left and right). In the left frontal lobe, male patients showed a significantly higher rate of CSF volume increase than controls (8.6% vs 6.4%). These differences in rates of volume change were observed in male and female patients, although only males showed significant time x diagnosis interactions. This negative finding in females should be interpreted with caution as the study was underpowered to detect change in women due to limited sample size. An exploratory analysis revealed that schizophrenia and nonschizophrenia psychotic disorders showed similar volume change patterns relative to controls. Change in clinical status was not correlated with longitudinal brain changes. Our results support progression of frontal lobe changes in males with adolescent-onset psychosis.
Collapse
Affiliation(s)
| | - Carmen Moreno
- Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Dolores Moreno
- Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Maite Burdalo
- Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Joost Janssen
- Department of Experimental Medicine,Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Mara Parellada
- Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Arantzazu Zabala
- Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - Celso Arango
- Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain,To whom correspondence should be addressed; Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Dr Esquerdo 46, Madrid 28007, Spain; tel: 34-914265057, fax: 34-914265108, e-mail:
| |
Collapse
|
18
|
Yoshihara Y, Sugihara G, Matsumoto H, Suckling J, Nishimura K, Toyoda T, Isoda H, Tsuchiya KJ, Takebayashi K, Suzuki K, Sakahara H, Nakamura K, Mori N, Takei N. Voxel-based structural magnetic resonance imaging (MRI) study of patients with early onset schizophrenia. Ann Gen Psychiatry 2008; 7:25. [PMID: 19102744 PMCID: PMC2628340 DOI: 10.1186/1744-859x-7-25] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2008] [Accepted: 12/22/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Investigation into the whole brain morphology of early onset schizophrenia (EOS) to date has been sparse. We studied the regional brain volumes in EOS patients, and the correlations between regional volume measures and symptom severity. METHODS A total of 18 EOS patients (onset under 16 years) and 18 controls matched for age, gender, parental socioeconomic status, and height were examined. Voxel-based morphometric analysis using the Brain Analysis Morphological Mapping (BAMM) software package was employed to explore alterations of the regional grey (GM) and white matter (WM) volumes in EOS patients. Symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS). RESULTS EOS patients had significantly reduced GM volume in the left parahippocampal, inferior frontal, and superior temporal gyri, compared with the controls. They also had less WM volume in the left posterior limb of the internal capsule and the left inferior longitudinal fasciculus. The positive symptom score of PANSS (higher values corresponding to more severe symptoms) was negatively related to GM volume in the bilateral posterior cingulate gyrus. The negative symptom score was positively correlated with GM volume in the right thalamus. As for the association with WM volume, the positive symptom score of PANSS was positively related to cerebellar WM (vermis region), and negatively correlated with WM in the brain stem (pons) and in the bilateral cerebellum (hemisphere region). CONCLUSION Our findings of regional volume alterations of GM and WM in EOS patients coincide with those of previous studies of adult onset schizophrenia patients. However, in brain regions that had no overall structural differences between EOS patients and controls (that is, the bilateral posterior cingulate gyrus, the right thalamus, the cerebellum, and the pons), within-subject analysis of EOS patients alone revealed that there were significant associations of the volume in these areas and the symptom severity. These findings suggest that at an early stage of the illness, especially for those with onset before brain maturation, a wide range of disturbed neural circuits, including these brain regions that show no apparent morphological changes, may contribute to the formation of the symptomatology.
Collapse
Affiliation(s)
- Yujiro Yoshihara
- Department of Psychiatry and Neurology, Hamamatsu University School of Medicine, Hamamatsu, Japan.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
19
|
De Masi S, Sampaolo L, Mele A, Morciano C, Cappello S, Meneghelli A, De Girolamo G. The Italian guidelines for early intervention in schizophrenia: development and conclusions. Early Interv Psychiatry 2008; 2:291-302. [PMID: 21352163 DOI: 10.1111/j.1751-7893.2008.00091.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
AIM The effectiveness of early intervention in schizophrenia is still under discussion. The guidelines described in the present paper were aimed at contributing to the current debate by providing Italian practitioners, families, patients and health managers with evidence-based information on early intervention. They also examined the diagnostic tools that are currently available for assessing different stages of psychotic disorders. METHODS A multidisciplinary panel of experts (the Guidelines Development Group) used a set of key-questions to develop an explicit search strategy to conduct a systematic review of the literature published from January 2000 to June 2006. Trained personnel then selected papers from those yielded by the literature search. The Guidelines Development Group's final recommendations were scaled according to the Italian National Guidelines System grading system. RESULTS The evidence available up to the time of the literature search does not allow for recommendation of early intervention targeting prodromal or at-risk patients to prevent progression from the prodromal phase to acute, full-blown psychosis, nor to improve prognosis. Conversely, identification and timely treatment of first-episode psychotic patients through specific early intervention programmes are highly recommended. CONCLUSIONS The Italian Guidelines on early intervention in schizophrenia are based on a comprehensive assessment of an updated, large-scale body of literature. They draw specific, evidence-based conclusions to assist clinicians and stakeholders in the planning and implementation of appropriate intervention programmes. Further research is needed to ascertain the effectiveness of early intervention in delaying or preventing the conversion to psychosis and improving prognosis in prodromal or at-risk patients. Further investigation is also required for first-episode and critical period patients.
Collapse
|
20
|
Abstract
OBJECTIVE The current study combined baseline voxel-based morphometry and 1-year clinical follow-up assessments to examine whether and where regional gray matter (GM) volumes differed between a control group and diagnostic subgroups of early-onset first-episode psychosis (FEP). METHOD Magnetic resonance imaging brain scans were obtained from 70 patients with early-onset FEP, and 51 non-FEP controls. Early-onset FEP was defined as age younger than 18 years and a duration of positive symptoms of less than 6 months. The age range of the sample was 7 to 18 years. After a 1-year follow-up, patients were stratified into three subgroups: schizophrenia (n = 25), bipolar I disorder (n = 20), and other psychoses (n = 25). Regional GM volumes of each patient subgroup were compared with those of the control group. RESULTS A follow-up diagnosis of schizophrenia was associated with GM volume deficits in the left medial and left middle frontal gyrus; bipolar I disorder was related to a GM volume deficit in the left medial frontal gyrus; and not having a follow-up diagnosis of schizophrenia or bipolar disorder was associated with smaller bilateral GM volumes in the insula and right middle occipital gyrus. CONCLUSIONS Left medial frontal GM volume deficits were common in the groups with schizophrenia and bipolar I disorder, which may point to shared underlying pathological findings.
Collapse
|
21
|
Assessing ventricular size: is subjective evaluation accurate enough? New MRI-based normative standards for 19-year-olds. Neuroradiology 2008; 50:1005-11. [DOI: 10.1007/s00234-008-0432-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2008] [Accepted: 06/25/2008] [Indexed: 11/25/2022]
|
22
|
Holzer L, Halfon O, Jaugey L. [Adolescent psychosis, can neuroscience improve prediction?]. Encephale 2008; 34:153-60. [PMID: 18597723 DOI: 10.1016/j.encep.2007.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2006] [Revised: 04/03/2007] [Accepted: 04/03/2007] [Indexed: 10/22/2022]
Abstract
Developments in the field of neuroscience have created a high level of interest in the subject of adolescent psychosis, particularly in relation to prediction and prevention. As the medical practice of adolescent psychosis and its treatment is characterised by a heterogeneity which is both symptomatic and evolutive, the somewhat poor prognosis of chronic development justifies the research performed: apparent indicators of schizophrenic disorders on the one hand and specific endophenotypes on the other are becoming increasingly important. The significant progresses made on the human genome show that the genetic predetermination in current psychiatric pathologies is complex and subject to moderating effects and there is therefore significant potential for nature-nurture interactions (between the environment and the genes). The road to be followed in researching the phenotypic expression of a psychosis gene is long and winding and is susceptible to many external influences at various levels with different effects. Neurobiological, neurophysiological, neuropsychological and neuroanatomical studies help to identify endophenotypes, which allow researchers to create identifying "markers" along this winding road. The endophenotypes could make it possible to redefine the nosological categories and enhance understanding of the physiopathology of schizophrenia. In a predictive approach, large-scale retrospective and prospective studies make it possible to identify risk factors, which are compatible with the neurodevelopmental hypothesis of schizophrenia. However, the predictive value of such markers or risk indicators is not yet sufficiently developed to offer a reliable early-detection method or possible schizophrenia prevention measures. Nonetheless, new developments show promise against the background of a possible future nosographic revolution, based on a paradigm shift. It is perhaps on the basis of homogeneous endophenotypes in particular that we will be able to understand what protects against, or indeed can trigger, psychosis irrespective of the clinical expression or attempts to isolate the common genetic and biological bases according to homogeneous clinical characteristics, which have to date, proved unsuccessful.
Collapse
Affiliation(s)
- L Holzer
- Centre thérapeutique de jour pour adolescents, service universitaire de psychiatrie de l'enfant et de l'adolescent, 48, avenue de Beaumont, 1012 Lausanne, Suisse.
| | | | | |
Collapse
|
23
|
Prasad KM, Keshavan MS. Structural cerebral variations as useful endophenotypes in schizophrenia: do they help construct "extended endophenotypes"? Schizophr Bull 2008; 34:774-90. [PMID: 18408230 PMCID: PMC2632444 DOI: 10.1093/schbul/sbn017] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Endophenotypes represent intermediate phenotypes on the putative causal pathway from the genotype to the phenotype. They offer a potentially valuable strategy to examine the molecular etiopathology of complex behavioral phenotypes such as schizophrenia. Neurocognitive and neurophysiological impairments that suggest functional impairments associated with schizophrenia have been proposed as endophenotypes. However, few studies have examined the structural variations in the brain that might underlie the functional impairments as useful endophenotypes for schizophrenia. Over the past three decades, there has been an impressive body of literature supporting brain structural alterations in schizophrenia. We critically reviewed the extant literature on the neuroanatomical variations in schizophrenia in this paper to evaluate their candidacy as endophenotypes and how useful they are in furthering the understanding of etiology and pathophysiology of schizophrenia. Brain morphometric measures meet many of the criteria set by different investigators, such as being robustly associated with schizophrenia, heritable, quantifiable, and present in unaffected family members more frequently than in the general population. We conclude that the brain morphometric alterations appear largely to meet the criteria for endophenotypes in psychotic disorders. Some caveats for the utility of endophenotypes are discussed. A proposal to combine more than one endophenotype ("extended endophenotype") is suggested. Further work is needed to examine how specific genes and their interactions with the environment may produce alterations in brain structure and function that accompany psychotic disorders.
Collapse
Affiliation(s)
- Konasale M. Prasad
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213
| | - Matcheri S. Keshavan
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213
- Department of Psychiatry and Behavioral Neuroscience, Wayne State University School of Medicine, Detroit, MI 48201
| |
Collapse
|
24
|
Arango C, Moreno C, Martínez S, Parellada M, Desco M, Moreno D, Fraguas D, Gogtay N, James A, Rapoport J. Longitudinal brain changes in early-onset psychosis. Schizophr Bull 2008; 34:341-53. [PMID: 18234701 PMCID: PMC2632400 DOI: 10.1093/schbul/sbm157] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Progressive losses of cortical gray matter volumes and increases in ventricular volumes have been reported in patients with childhood-onset schizophrenia (COS) during adolescence. Longitudinal studies suggest that the rate of cortical loss seen in COS during adolescence plateaus during early adulthood. Patients with first-episode adolescent-onset schizophrenia show less marked progressive changes, although the number of studies in this population is small. Some studies show that, although less exaggerated, progressive changes are also present in nonschizophrenia early-onset psychosis. The greater loss of brain tissue seen in COS, even some years after the first episode, as compared to adolescent- or adult-onset schizophrenia may be due to variables such as sample bias (more severe, treatment refractory sample of childhood-onset patients studied), a process uniquely related to adolescent development in COS, differential brain effects of drug treatment in this population, clinical outcome, or interactions among these variables. Findings from both cross-sectional studies of first-episode patients and longitudinal studies in COS and adolescent onset support the concept of early-onset schizophrenia as a progressive neurodevelopmental disorder with both early and late developmental abnormalities. Future studies should look for correlates at a cellular level and for pathophysiological explanations of volume changes in these populations. The association of risk genes involved in circuitries associated with schizophrenia and their relationship to developmental trajectories is another promising area of future research.
Collapse
Affiliation(s)
- Celso Arango
- Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
| | - Carmen Moreno
- Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Salvador Martínez
- Instituto de Neurociencias, Universidad Miguel Hernandez, Alicante, Spain
| | - Mara Parellada
- Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Manuel Desco
- Unidad de Medicina y Cirugía Experimental, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - David Fraguas
- Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Nitin Gogtay
- Child Psychiatry Branch, National Institute of Mental Health, Room 3N202, Building 10, Center Drive, Bethesda, MD 20892
| | - Anthony James
- Highfield Adolescent Unit, Warneford Hospital, Oxford, UK
| | - Judith Rapoport
- Child Psychiatry Branch, National Institute of Mental Health, Room 3N202, Building 10, Center Drive, Bethesda, MD 20892
| |
Collapse
|
25
|
Karlsgodt KH, van Erp TGM, Poldrack RA, Bearden CE, Nuechterlein KH, Cannon TD. Diffusion tensor imaging of the superior longitudinal fasciculus and working memory in recent-onset schizophrenia. Biol Psychiatry 2008; 63:512-8. [PMID: 17720147 DOI: 10.1016/j.biopsych.2007.06.017] [Citation(s) in RCA: 260] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2007] [Revised: 06/12/2007] [Accepted: 06/14/2007] [Indexed: 11/15/2022]
Abstract
BACKGROUND Structural and functional abnormalities in frontal-parietal circuitry are thought to be associated with working memory (WM) deficits in patients with schizophrenia. This study examines whether recent-onset schizophrenia is associated with anatomical changes in the superior longitudinal fasciculus (SLF), the main frontal-parietal white matter connection, and whether the integrity of the SLF is related to WM performance. METHODS We applied a novel registration approach (Tract-Based Spatial Statistics [TBSS]) to diffusion tensor imaging data to examine fractional anisotropy (FA) in the left and right SLF in 12 young adult patients with recent-onset schizophrenia and 17 matched control subjects. RESULTS Schizophrenia patients showed lower FA values than control subjects across the entire SLF, with particular deficits on the left SLF. Fractional anisotropy values were correlated with performance on a verbal WM task in both patient and control groups in the left but not right SLF. CONCLUSIONS Recent-onset schizophrenia patients show deficits in frontal-parietal connections, key components of WM circuitry. Moreover, the integrity of this physiological connection predicted performance on a verbal WM task, indicating that this structural change may have important functional implications. These findings support the view that schizophrenia is a disorder of brain connectivity and implicate white matter changes detectable in the early phases of the illness as one source of this dysfunction.
Collapse
Affiliation(s)
- Katherine H Karlsgodt
- Department of Psychology, University of California, Los Angeles, California 90095-1563, USA.
| | | | | | | | | | | |
Collapse
|
26
|
Zabala A, Sánchez-González J, Parellada M, Moreno DM, Reig S, Burdalo MT, Robles O, Desco M, Arango C. Findings of proton magnetic resonance spectometry in the dorsolateral prefrontal cortex in adolescents with first episodes of psychosis. Psychiatry Res 2007; 156:33-42. [PMID: 17764911 DOI: 10.1016/j.pscychresns.2006.12.016] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2006] [Revised: 12/14/2006] [Accepted: 12/26/2006] [Indexed: 11/23/2022]
Abstract
Knowledge of the neurobiology of early onset psychosis is limited. We used proton magnetic resonance spectroscopy to investigate the possible existence of dorsolateral prefrontal brain biochemical abnormalities in adolescents with psychosis and to determine possible differential effects related to specific psychotic diagnoses. We measured the ratios of N-acetyl-aspartate (NAA), choline (Cho), and creatine (Cr) to water in two groups of adolescents with a first episode of psychosis (schizophrenia n=8; non-schizophrenia n=15) and in 32 healthy controls matched for age, gender, and years of education. Proton magnetic resonance spectroscopy at 1.5 T was used to study two 6.75-cc voxels placed in the left and right dorsolateral prefrontal region. The schizophrenia patients presented statistically significant reductions in NAA/water levels in the left dorsolateral prefrontal voxel as compared with non-schizophrenia patients and healthy controls. No significant differences were detected between groups for NAA/water in the right dorsolateral prefrontal voxel or for Cho/water and Cr/water levels in any hemisphere. A reduction of the NAA/water level in the left dorsolateral prefrontal region may be selectively present at the onset of psychosis during adolescence in patients who later progress to schizophrenia, but not in those who later progress to other psychotic disorders.
Collapse
Affiliation(s)
- Arantzazu Zabala
- Adolescent Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, 28009 Madrid, Spain.
| | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Abstract
Neuroimaging and electrophysiological investigations have demonstrated numerous differences in brain morphology and function of chronic schizophrenia patients compared to healthy controls. Studying patients at the beginning of their disease without the confounding effects of chronicity, medication, and institutionalization may provide a better understanding of schizophrenia. Recently, at many institutions around the world, special projects have been launched for specialized treatment and research of this interesting patient group. Using the PubMed search engine in this update, the authors summarize recent investigations between January 2002 and September 2006 that focus on whether signs of disconnectivity already exist early in the disease process. They discuss gray and white matter changes, their impact on symptomatology, electroencephalogram-based studies on connectivity, and possible influences of medication. NEUROSCIENTIST 14(1):19—45, 2008. DOI: 10.1177/1073858406298391
Collapse
Affiliation(s)
- S Begré
- Department of General Internal Medicine, Division of Psychosomatic Medicine, University Hospital Bern, Switzerland.
| | | |
Collapse
|
28
|
Castro-Fornieles J, Parellada M, Gonzalez-Pinto A, Moreno D, Graell M, Baeza I, Otero S, Soutullo CA, Crespo-Facorro B, Ruiz-Sancho A, Desco M, Rojas-Corrales O, Patiño A, Carrasco-Marin E, Arango C. The child and adolescent first-episode psychosis study (CAFEPS): design and baseline results. Schizophr Res 2007; 91:226-37. [PMID: 17267179 DOI: 10.1016/j.schres.2006.12.004] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2006] [Revised: 11/26/2006] [Accepted: 12/09/2006] [Indexed: 01/03/2023]
Abstract
OBJECTIVE The child and adolescent first-episode psychosis study (CAFEPS) is a multicenter, two-year, longitudinal project aiming to evaluate different clinical, neuropsychological, neuroimaging, biochemical, immunological, and genetic variables and treatment and prognostic factors in these patients. This paper describes the methods and rationale behind the study and the general characteristics of the sample. METHOD At six different centers, from March 2003 through November 2005, we consecutively recruited 110 patients, ages 9-17 years, who presented with a first psychotic episode. Controls were recruited from the same geographic areas and were matched for gender and age. RESULTS Patients had lower socioeconomic status (SES) (p=0.018) and parental years of education (p<0.001) than controls. The percentage of patients recruited increased with age (p<0.001) and there was a higher percentage of males (p<0.001). The total mean PANSS score was 89.03+/-20.1, the positive score 23.8+/-6.5 and the negative score 20.02+/-8.8. There were no significant differences between the genders with respect to age, parental years of education, SES, or scores in premorbid adjustment or general functioning. There were statistically significant positive correlations between age and positive symptoms and between all PANSS subscales and the Disability Assessment Schedule, and negative correlations between positive symptoms and global functioning. Diagnoses after the baseline evaluation were: psychotic disorder not otherwise specified (NOS) 35.5%, schizophreniform disorder 24.5%, mood disorder with psychotic symptoms 22.7%, schizophrenia 10%, schizoaffective disorder 2.7%, and other psychotic disorders 4.5%. Patients had worse premorbid adjustment (p<0.001) and global functioning (p<0.001) than controls after controlling for SES. CONCLUSIONS Infancy and adolescence adjustment and global functioning are lower in children and adolescents with psychotic disorders than in controls, severity of symptoms are related to general disability, and the most frequent diagnoses are psychotic disorders NOS.
Collapse
Affiliation(s)
- Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic of Neurosciences, Institut d'Investigacions Biomèdiques August Pi Sunyer, Hospital Clínic Universitari of Barcelona, Villarroel, Spain.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Pagsberg AK, Baaré WFC, Raabjerg Christensen AM, Fagerlund B, Hansen MB, Labianca J, Krabbe K, Aarkrog T, Paulson OB, Hemmingsen RP. Structural brain abnormalities in early onset first-episode psychosis. J Neural Transm (Vienna) 2006; 114:489-98. [PMID: 17024324 DOI: 10.1007/s00702-006-0573-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2006] [Accepted: 08/27/2006] [Indexed: 11/29/2022]
Abstract
BACKGROUND Brain morphometry in children and adolescents with first-episode psychosis offer a unique opportunity for pathogenetic investigations. METHODS We compared high-resolution 3D T1-weighted magnetic resonance images of the brain in 29 patients (schizophrenia, schizotypal disorder, delusional disorder or other non-organic psychosis), aged 10-18 to those of 29 matched controls, using optimized voxel-based morphometry. RESULTS Psychotic patients had frontal white matter abnormalities, but expected (regional) gray matter reductions were not observed. Post hoc analyses revealed that schizophrenia patients (n = 15) had significantly larger lateral ventricles as compared to controls. Duration and dose of antipsychotics correlated negatively with global gray matter volume in minimally medicated patients (n = 18). CONCLUSION Findings of white matter changes and enlarged lateral ventricles already at illness onset in young schizophrenia spectrum patients, suggests aberrant neurodevelopmental processes in the pathogenesis of these disorders. Gray matter volume changes, however, appear not to be a key feature in early onset first-episode psychosis.
Collapse
Affiliation(s)
- A K Pagsberg
- Department of Child and Adolescent Psychiatry, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark.
| | | | | | | | | | | | | | | | | | | |
Collapse
|