Diagnosis-Related Regional Gray Matter Loss Over Two Years in First Episode Schizophrenia and Bipolar Disorder

• Published in: Biological psychiatry (1969) Vol. 58; no. 9; pp. 713 - 723
• Main Authors: Farrow, Tom F.D., Whitford, Thomas J., Williams, Leanne M., Gomes, Lavier, Harris, Anthony W.F.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.11.2005; Elsevier Science
• Subjects: Adolescent; Adult; Adult and adolescent clinical studies; Biological and medical sciences; bipolar disorder; Bipolar Disorder - diagnostic imaging; Bipolar Disorder - pathology; Bipolar disorders; Brain - diagnostic imaging; Brain - growth & development; Brain - pathology; Brain Mapping; Disease Progression; Female; First episode psychosis; Follow-Up Studies; gray matter; Humans; Image Processing, Computer-Assisted; longitudinal; Magnetic Resonance Imaging; Male; Medical sciences; Models, Neurological; Mood disorders; Positron-Emission Tomography; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychoses; Schizophrenia; Schizophrenia - diagnostic imaging; Schizophrenia - pathology; voxel based morphometry; white matter; First episode psychosis; white matter; bipolar disorder; gray matter; schizophrenia; longitudinal; voxel based morphometry; Mood disorder; Human; Grey matter; Schizophrenia; Bipolar disorder; White matter; Psychosis; First episode; Follow up study; Diagnosis; Morphometry
• ISSN: 0006-3223; 1873-2402
• DOI: 10.1016/j.biopsych.2005.04.033

We examined gray- and white-matter brain volumes in first episode psychosis (FEP) at initial presentation and at two-year follow-up. We predicted that FEP subjects would show longitudinal reductions in fronto-temporal gray- and white-matter volumes compared with controls. Furthermore, we expected groups to be differentiated by diagnosis-related reductions. Twenty-five schizophrenia and 8 bipolar disorder FEP patients underwent a structural MRI scan at first presentation and 2 years later. Matched healthy subjects (n = 22) underwent a single identical scan. At initial presentation FEP subjects had significantly less gray- and white-matter than healthy subjects. Diagnostic dissociations were revealed both at first presentation and at follow-up. In schizophrenia patients, gray-matter deficits were observed in lateral and medial frontal regions and in bilateral posterior temporal lobe regions, with additional extensive losses over time in lateral fronto-temporal regions and left anterior cingulate gyrus. By contrast, gray matter deficit in bipolar patients was localized to bilateral inferior temporal gyri with additional loss over time observed only in the anterior cingulate cortex. The results are consistent with a dual process model of psychosis, in which the diagnosis-related gray matter loss is determined by neurodevelopmental gray-matter volumetric differences which predate symptom onset, and diagnosis-related neurodegenerative gray-matter loss over time.