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Cerebral cortical alterations in adolescent early-onset psychosis: a surface-based morphometry mega-analysis
Stener Nerland1,2, Claudia Barth1,2, Kjetil Nordbø Jørgensen2,3
1Division for Mental Health and Substance Abuse, Diakonhjemmet Hospital, Oslo, Norway.
Medrxiv : the Preprint Server for Health Sciences
|June 10, 2025
Summary
Adolescents with early-onset psychosis (EOP) exhibit widespread reductions in cortical thickness, surface area, volume, and gyrification compared to controls. These brain alterations in EOP are similar to adult schizophrenia and bipolar disorder but more pronounced in surface area.
Area of Science:
- Neuroscience
- Psychiatry
- Developmental Psychology
Background:
- Cortical brain morphology in early-onset psychosis (EOP) is not well understood due to low incidence and recruitment challenges.
- Previous research has primarily focused on adult populations with psychosis.
Purpose of the Study:
- To investigate cortical brain morphology differences in adolescents with EOP compared to healthy controls.
- To explore the relationship between cortical alterations and clinical factors in EOP.
- To compare the pattern of cortical changes in EOP with those observed in adult schizophrenia and bipolar disorder.
Main Methods:
- Pooled T1-weighted MRI data from 387 adolescents with EOP and 338 healthy controls across nine international research sites.
- Harmonized processing using FreeSurfer to extract cortical thickness, surface area, volume, and Local Gyrification Index (LGI) from 34 bilateral regions.
- Univariate regression analyses and subgroup analyses to examine case-control differences and clinical correlations.
Main Results:
- Adolescents with EOP showed widespread reductions in cortical thickness, surface area, volume, and LGI compared to controls.
- Early-onset schizophrenia subgroup exhibited more pronounced differences in area, volume, and LGI.
- Cortical alterations in EOP mirrored patterns in adult schizophrenia and bipolar disorder but were more extensive in surface area.
- Negative symptoms correlated with smaller left lingual volumes; antidepressant use was associated with smaller right rostral anterior cingulate area and volume.
Conclusions:
- Adolescents with EOP demonstrate extensive cortical alterations, suggesting aberrant neurodevelopment.
- The findings highlight significant morphological differences in the developing brain in EOP.
- Cortical changes in EOP share similarities with adult psychotic disorders but are quantitatively distinct, particularly in surface area.
