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. 2012 May;38(3):519-30.
doi: 10.1093/schbul/sbq113. Epub 2010 Oct 7.

Progressive structural brain changes during development of psychosis

Tim B Ziermans  1 , Patricia F Schothorst, Hugo G Schnack, P Cédric M P Koolschijn, René S Kahn, Herman van Engeland, Sarah Durston
Affiliations

Progressive structural brain changes during development of psychosis

Tim B Ziermans et al. Schizophr Bull. 2012 May.

Abstract

Background: Ultra-high risk (UHR) for psychosis has been associated with widespread structural brain changes in young adults. The onset of these changes and their subsequent progression over time are not well understood.

Methods: Rate of brain change over time was investigated in 43 adolescents at UHR for psychosis compared with 30 healthy controls. Brain volumes (total brain, gray matter, white matter [WM], cerebellum, and ventricles), cortical thickness, and voxel-based morphometry were measured at baseline and at follow-up (2 y after baseline) and compared between UHR individuals and controls. Post hoc analyses were done for UHR individuals who became psychotic (N = 8) and those who did not (N = 35).

Results: UHR individuals showed a smaller increase in cerebral WM over time than controls and more cortical thinning in the left middle temporal gyrus. Post hoc, a more pronounced decrease over time in total brain and WM volume was found for UHR individuals who became psychotic relative to controls and a greater decrease in total brain volume than individuals who were not psychotic. Furthermore, UHR individuals with subsequent psychosis displayed more thinning than controls in widespread areas in the left anterior cingulate, precuneus, and temporo-parieto-occipital area. Volume loss in the individuals who developed psychosis could not be attributed to medication use.

Conclusion: The development of psychosis during adolescence is associated with progressive structural brain changes around the time of onset. These changes cannot be attributed to (antipsychotic) medication use and are therefore likely to reflect a pathophysiological process related to clinical manifestation of psychosis.

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Figures

Fig. 1.
Fig. 1.
Change in total brain (left panel) and white matter (right panel) volume per year for controls, ultra–high risk individuals without psychosis (UHR-NP) and with psychosis (UHR-P). Individual data and group means are shown.
Fig. 2.
Fig. 2.
Cortical thinning in the left hemisphere for ultra–high risk individuals with psychosis (UHR-P) compared with controls, controlled for age, sex, handedness and total IQ. The critical F value was 8.96. Boxes illustrate mean standardized residuals for all groups ± standard errors for peak vertices in anterior cingulate cortex (left) and middle temporal gyrus (right).
See this image and copyright information in PMC

References

    1. Pantelis C, Yucel M, Wood SJ, et al. Structural brain imaging evidence for multiple pathological processes at different stages of brain development in schizophrenia. Schizophr Bull. 2005;31:672–696. - PubMed
    1. Lawrie SM, McIntosh AM, Hall J, Owens DG, Johnstone EC. Brain structure and function changes during the development of schizophrenia: the evidence from studies of subjects at increased genetic risk. Schizophr Bull. 2008;34:330–340. - PMC - PubMed
    1. Wood SJ, Pantelis C, Yung AR, Velakoulis D, McGorry PD. Brain changes during the onset of schizophrenia: implications for neurodevelopmental theories. Med J Aust. 2009;190:S10–S13. - PubMed
    1. Pantelis C, Yucel M, Bora E, et al. Neurobiological markers of illness onset in psychosis and schizophrenia: the search for a moving target. Neuropsychol Rev. 2009;19:385–398. - PubMed
    1. McGorry PD, Yung AR, Phillips LJ. The ”close-in” or ultra high-risk model: a safe and effective strategy for research and clinical intervention in prepsychotic mental disorder. Schizophr Bull. 2003;29:771–790. - PMC - PubMed

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