Niche Lab - Neuroimaging In Childhood

Progressive Structural Brain Changes During Development of Psychosis

Progressive Structural Brain Changes During Development of Psychosis

 

Tim B. Ziermans, Patricia F. Schothorst, Hugo G. Schnack, P. Cedric M. P. Koolschijn, Rene S. Kahn,
Herman van Engeland, and Sarah Durston

Background: Ultra-high risk (UHR) for psychosis has
been associated with widespread structural brain
changes in young adults. The onset of these changes
and their subsequent progression over time are not
well understood. Methods: Rate of brain change over
time was investigated in 43 adolescents at UHR for psychosis
compared with 30 healthy controls. Brain volumes
(total brain, gray matter, white matter [WM], cerebellum,
and ventricles), cortical thickness, and voxel-based
morphometry were measured at baseline and at followup
(2 y after baseline) and compared between UHR individuals
and controls. Post hoc analyses were done for
UHR individuals who became psychotic (N 5 8) and
those who did not (N 5 35). Results: UHR individuals
showed a smaller increase in cerebral WM over time
than controls and more cortical thinning in the left middle
temporal gyrus. Post hoc, a more pronounced decrease
over time in total brain and WM volume was
found for UHR individuals who became psychotic relative
to controls and a greater decrease in total brain
volume than individuals who were not psychotic. Furthermore,
UHR individuals with subsequent psychosis
displayed more thinning than controls in widespread
areas in the left anterior cingulate, precuneus, and
temporo-parieto-occipital area. Volume loss in the individuals
who developed psychosis could not be attributed
to medication use. Conclusion: The development of psychosis
during adolescence is associated with progressive
structural brain changes around the time of onset. These
changes cannot be attributed to (antipsychotic) medication
use and are therefore likely to reflect a pathophysiological
process related to clinical manifestation of
psychosis.

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