Brain surface contraction mapped in first-episode schizophrenia: a longitudinal magnetic resonance imaging study

• Published in: Molecular psychiatry Vol. 14; no. 10; pp. 976 - 986
• Main Authors: Sun, D, Stuart, G W, Jenkinson, M, Wood, S J, McGorry, P D, Velakoulis, D, van Erp, T G M, Thompson, P M, Toga, A W, Smith, D J, Cannon, T D, Pantelis, C
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.10.2009; Nature Publishing Group
• Subjects: Adolescent; Adult; Atrophy; Behavioral Sciences; Biological Psychology; Brain; Brain - pathology; Brain Mapping; Case-Control Studies; Complications and side effects; Diagnosis; Female; Frontal lobe; Health aspects; Humans; Hypotheses; Illnesses; Longitudinal Studies; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Medical imaging; Medicine; Medicine & Public Health; Mental disorders; Neural networks; Neuroimaging; Neurosciences; Organ Size; Original; original-article; Pharmacotherapy; Psychiatry; Schizophrenia; Schizophrenia - pathology; United States; Los Angeles California; California; Australia; United States > US; brain mapping; brain development; magnetic resonance imaging; schizophrenia; structural; longitudinal studies
• ISSN: 1359-4184; 1476-5578; 1476-5578
• DOI: 10.1038/mp.2008.34

Schizophrenia is associated with structural brain abnormalities, but the timing of onset and course of these changes remains unclear. Longitudinal magnetic resonance imaging (MRI) studies have demonstrated progressive brain volume decreases in patients around and after the onset of illness, although considerable discrepancies exist regarding which brain regions are affected. The anatomical pattern of these progressive changes in schizophrenia is largely unknown. In this study, MRI scans were acquired repeatedly from 16 schizophrenia patients approximately 2 years apart following their first episode of illness, and also from 14 age-matched healthy subjects. Cortical Pattern Matching, in combination with Structural Image Evaluation, using Normalisation, of Atrophy, was applied to compare the rates of cortical surface contraction between patients and controls. Surface contraction in the dorsal surfaces of the frontal lobe was significantly greater in patients with first-episode schizophrenia (FESZ) compared with healthy controls. Overall, brain surface contraction in patients and healthy controls showed similar anatomical patterns, with that of the former group exaggerated in magnitude across the entire brain surface. That the pattern of structural change in the early course of schizophrenia corresponds so closely to that associated with normal development is consistent with the hypothesis that a schizophrenia-related factor interacts with normal adolescent brain developmental processes in the pathophysiology of schizophrenia. The exaggerated progressive changes seen in patients with schizophrenia may reflect an increased rate of synaptic pruning, resulting in excessive loss of neuronal connectivity, as predicted by the late neurodevelopmental hypothesis of the illness.