Diagnosis-related regional gray matter loss over two years in first episode schizophrenia and bipolar disorder.
BACKGROUND
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Brain Dynamics Centre, Westmead Hospital, Westmead; SCANLab, Department of Academic Clinical Psychiatry, University of Sheffield, United Kingdom.
Tom F D
TF
Farrow
Thomas J
TJ
Whitford
Leanne M
LM
Williams
Lavier
L
Gomes
Anthony W F
AW
Harris
D000293:Adolescent; D000328:Adult; D001714:Bipolar Disorder / Q000000981:diagnostic imaging / Q000473:pathology*; D001921:Brain / Q000000981:diagnostic imaging / Q000254:growth & development / Q000473:pathology*; D001931:Brain Mapping; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008959:Models, Neurological; D049268:Positron-Emission Tomography; D012559:Schizophrenia / Q000000981:diagnostic imaging / Q000473:pathology*