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Progressive brain changes in children and adolescents with first-episode psychosis

Celso Arango1, Marta Rapado-Castro, Santiago Reig

  • 1Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain. carango@hggm.es

Archives of General Psychiatry
|January 4, 2012
PubMed

Insights

Pediatric patients with schizophrenia experienced greater gray matter (GM) loss in the frontal lobe compared to controls. These progressive brain changes may indicate a poorer prognosis in early-onset psychosis.

Area of Science:

  • Neuroscience
  • Psychiatry
  • Radiology

Background:

  • Childhood-onset schizophrenia is associated with progressive gray matter (GM) loss.
  • It remains unclear if pediatric patients with other psychoses share similar brain changes.

Purpose of the Study:

  • To investigate the progression of brain changes in first-episode early-onset psychosis.
  • To determine the relationship between these changes, diagnosis, and prognosis over a 2-year follow-up period.

Main Methods:

  • A prospective, multicenter, naturalistic 2-year follow-up study.
  • Involved 110 patients with early-onset psychosis and 98 healthy controls.
  • Utilized magnetic resonance imaging (MRI) to assess brain gray matter (GM) and cerebrospinal fluid (CSF) volumes.

Main Results:

  • Schizophrenia patients showed significantly greater GM volume loss in the frontal lobe and increased frontal CSF volume compared to controls.
  • Total GM and left parietal GM changes were also significantly different in schizophrenia patients.
  • No significant differences were observed in patients with bipolar disorder.

Conclusions:

  • Patients with schizophrenia or other psychoses exhibit accelerated GM volume loss and CSF volume increase in the frontal lobe.
  • Progressive brain changes are more pronounced in schizophrenia than in bipolar disorder.
  • These observed brain volume alterations may serve as potential markers for poorer prognosis in early-onset psychosis.
Abstract

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