title: Childhood-onset schizophrenia: progressive brain changes during adolescence.
abstract: BACKGROUND
  Previous NIMH childhood onset schizophrenia (COS) anatomic brain MRI studies found progression of ventricular volume and other structural brain anomalies at 2-year follow up across mean ages 14 to 16 years. However, studies in adult patients generally do not show progression of ventricular volume or correlation of ventricular volume with duration of illness. To address issues of progression of brain anomalies in schizophrenia, this report extends previous studies to include a third longitudinal scan, uses a larger sample size, and includes measures of the amygdala and hippocampus.
  
  
  METHODS
  Volumes of the total cerebrum, lateral ventricles, hippocampus, and amygdala were quantified on 208 brain magnetic resonance imaging scans from 42 adolescents with COS (23 with one or more repeat scan) and 74 age- and gender-matched controls (36 with one or more repeat scan). A statistical technique permitting combined use of cross-sectional and longitudinal data was used to assess age-related changes, linearity, and diagnostic group differences.
  
  
  RESULTS
  Differential nonlinear progression of brain anomalies was seen during adolescence with the total cerebrum and hippocampus decreasing and lateral ventricles increasing in the COS group. The developmental curves for these structures reached an asymptote by early adulthood for the COS group and did not significantly change with age in the control group.
  
  
  CONCLUSIONS
  These findings reconcile less striking progression of anatomic brain images usually seen for adult schizophrenia and complement other data consistent with time-limited, diagnostic-specific decreases in brain tissue. Adolescence appears to be a unique period of differential brain development in schizophrenia.
authors.affiliation: Child Psychiatry Branch, National Institute of Mental Health, Bethesda, MD 20892, USA.
authors.forename: J N
authors.initials: JN
authors.lastname: Giedd
authors.forename: N O
authors.initials: NO
authors.lastname: Jeffries
authors.forename: J
authors.initials: J
authors.lastname: Blumenthal
authors.forename: F X
authors.initials: FX
authors.lastname: Castellanos
authors.forename: A C
authors.initials: AC
authors.lastname: Vaituzis
authors.forename: T
authors.initials: T
authors.lastname: Fernandez
authors.forename: S D
authors.initials: SD
authors.lastname: Hamburger
authors.forename: H
authors.initials: H
authors.lastname: Liu
authors.forename: J
authors.initials: J
authors.lastname: Nelson
authors.forename: J
authors.initials: J
authors.lastname: Bedwell
authors.forename: L
authors.initials: L
authors.lastname: Tran
authors.forename: M
authors.initials: M
authors.lastname: Lenane
authors.forename: R
authors.initials: R
authors.lastname: Nicolson
authors.forename: J L
authors.initials: JL
authors.lastname: Rapoport
mesh_terms: D000293:Adolescent; D000328:Adult; D000679:Amygdala / Q000002:abnormalities / Q000473:pathology; D001921:Brain / Q000002:abnormalities* / Q000473:pathology; D002540:Cerebral Cortex / Q000002:abnormalities / Q000473:pathology; D002552:Cerebral Ventricles / Q000002:abnormalities / Q000473:pathology; D002648:Child; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D006624:Hippocampus / Q000002:abnormalities / Q000473:pathology; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D019965:Neurocognitive Disorders / Q000175:diagnosis*; D012561:Schizophrenia, Childhood / Q000175:diagnosis*