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What determines continuing grey matter changes in first-episode schizophrenia and affective psychosis?

Published online by Cambridge University Press:  02 September 2014

P. G. P. Rosa ,
M. V. Zanetti ,
F. L. S. Duran ,
L. C. Santos ,
P. R. Menezes ,
M. Scazufca ,
R. M. Murray ,
G. F. Busatto  and
M. S. Schaufelberger
P. G. P. Rosa
Affiliation:
Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Brazil Centre for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, Brazil
M. V. Zanetti
Affiliation:
Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Brazil Centre for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, Brazil
F. L. S. Duran
Affiliation:
Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Brazil Centre for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, Brazil
L. C. Santos
Affiliation:
Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Brazil Centre for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, Brazil
P. R. Menezes
Affiliation:
Department of Preventive Medicine, Faculty of Medicine, University of São Paulo, Brazil
M. Scazufca
Affiliation:
Laboratory of Psychopharmacology and Clinical Psychophysiology (LIM-23), Faculty of Medicine, Institute of Psychiatry, University of São Paulo, Brazil
R. M. Murray
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's College London, UK
G. F. Busatto
Affiliation:
Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Brazil Centre for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, Brazil
M. S. Schaufelberger*
Affiliation:
Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Brazil Centre for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, Brazil Department of Neuroscience and Behaviour, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
*
*Address for correspondence: Dr M. S. Schaufelberger, Departamento de Neurociências e Ciências do Comportamento, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Avenida dos Bandeirantes, 3900, Monte Alegre, 14049-900, Ribeirão Preto, SP, Brazil. (Email: maristela_ss@yahoo.com.br)
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Abstract

Background.

Magnetic resonance imaging (MRI) studies have shown that brain abnormalities in psychosis might be progressive during the first years of illness. We sought to determine whether first-episode psychosis (FEP) subjects show progressive regional grey matter (GM) changes compared with controls, and whether those changes are associated with diagnosis, illness course or antipsychotic (AP) use.

Method.

Thirty-two subjects with first-episode schizophrenia-spectrum disorders (FESZ), 24 patients with first-episode affective psychoses (FEAP) and 34 controls recruited using a population-based design underwent structural MRI scanning at baseline and at a 5-year follow-up. Regional GM volumes were assessed with voxel-based morphometry (VBM). Patients were treated at community settings, and about half of them remained mainly untreated.

Results.

No significant progressive changes in GM regional volumes were observed in either the FESZ or FEAP group overall. However, FESZ subjects with a non-remitting course showed GM decrements in the left superior temporal gyrus (STG) and insula relative to remitted FESZ subjects. Non-remitted FEAP subjects exhibited a GM decrease in the dorsolateral prefrontal cortex (DLPFC) bilaterally in comparison to remitted FEAP subjects. Among FESZ subjects, AP use was associated with regional GM decrements in the right insula and increments in the cerebellum.

Conclusions.

Our results suggest that the progression of brain abnormalities in FEP subjects is restricted to those with a poor outcome and differs between diagnosis subgroups. AP intake is associated with a different pattern of GM reductions over time.

Keywords

Bipolar disordermagnetic resonance imagingmajor depressive disorderpsychosisschizophreniavoxel-based morphometry
Type
Original Articles
Information
Psychological Medicine , Volume 45 , Issue 4 , March 2015 , pp. 817 - 828
Copyright
Copyright © Cambridge University Press 2014 

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