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Celso Arango1, Carmen Moreno, Salvador Martínez

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Childhood-onset schizophrenia (COS) involves progressive brain changes, with gray matter loss slowing in adulthood. Early-onset psychosis also shows progressive changes, suggesting a neurodevelopmental disorder.

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Developmental Psychology

Background:

  • Childhood-onset schizophrenia (COS) is associated with progressive gray matter loss and ventricular enlargement during adolescence.
  • Longitudinal studies indicate a plateau in cortical loss in COS patients entering early adulthood.
  • First-episode adolescent-onset schizophrenia shows less pronounced progressive changes, though data is limited.

Purpose of the Study:

  • To review and synthesize findings on brain volume changes in early-onset schizophrenia and related disorders.
  • To explore potential reasons for greater brain tissue loss in COS compared to adolescent- or adult-onset schizophrenia.
  • To support the concept of early-onset schizophrenia as a progressive neurodevelopmental disorder.

Main Methods:

  • Review of longitudinal and cross-sectional studies on brain imaging in early-onset schizophrenia and psychosis.
  • Analysis of cortical gray matter volumes and ventricular volumes.
  • Comparison of neurodevelopmental trajectories across different onset ages of schizophrenia.

Main Results:

  • Progressive gray matter loss and ventricular enlargement are observed in childhood-onset schizophrenia (COS) during adolescence.
  • Cortical loss rate in COS appears to stabilize in early adulthood.
  • Nonschizophrenia early-onset psychosis also exhibits progressive brain changes, albeit less severe than in COS.

Conclusions:

  • Early-onset schizophrenia is characterized as a progressive neurodevelopmental disorder with abnormalities in both early and late development.
  • Greater brain tissue loss in COS may stem from sample bias, unique developmental processes, treatment effects, or clinical outcomes.
  • Future research should investigate cellular correlates, pathophysiological mechanisms, and the role of risk genes in the developmental trajectories of early-onset schizophrenia.