Brain change trajectories that differentiate the major psychoses

Area of Science:

• Neuroimaging
• Psychiatry
• Neuroscience

Background:

• Bipolar disorder and schizophrenia are heritable psychotic disorders with overlapping brain phenotypes.
• Differentiating these disorders clinically and through brain imaging remains challenging.
• Longitudinal studies suggest potential differences in brain structure trajectories.

Purpose of the Study:

• To review longitudinal structural neuroimaging studies comparing bipolar disorder and schizophrenia.
• To investigate if differing brain structure trajectories can differentiate these disorders.

Main Methods:

• Narrative review of studies published up to May 2016.
• Searched MEDLINE and Web of Science databases.
• Included 10 longitudinal structural MRI studies comparing bipolar disorder and schizophrenia.

Main Results:

• Schizophrenia exhibits progressive grey matter loss in fronto-temporal cortical regions.
• Bipolar disorder shows a similar, less severe trajectory with distinct cingulate subregion involvement.
• Illness-specific longitudinal trajectories of morphological change were implicated.

Conclusions:

• Initial evidence suggests differential longitudinal brain trajectories between bipolar disorder and schizophrenia.
• These trajectories appear influenced by brain maturation.
• Further research is needed due to the limited number of studies.