Brain volume in first-episode schizophrenia: systematic review and meta-analysis of magnetic resonance imaging studies.
BACKGROUND
Studies of people with schizophrenia assessed using magnetic resonance imaging (MRI) usually include patients with first-episode and chronic disease, yet brain abnormalities may be limited to those with chronic schizophrenia.


OBJECTIVE
To determine whether patients with a first episode of schizophrenia have characteristic brain abnormalities.


METHODS
Systematic review and meta-analysis of 66 papers comparing brain volume in patients with a first psychotic episode with volume in healthy controls.


RESULTS
A total of 52 cross-sectional studies included 1424 patients with a first psychotic episode; 16 longitudinal studies included 465 such patients. Meta-analysis suggests that whole brain and hippocampal volume are reduced (both P<0.0001) and that ventricular volume is increased (P<0.0001) in these patients relative to healthy controls.


CONCLUSIONS
Average volumetric changes are close to the limit of detection by MRI methods. It remains to be determined whether schizophrenia is a neurodegenerative process that begins at about the time of symptom onset, or whether it is better characterised as a neurodevelopmental process that produces abnormal brain volumes at an early age.
Steen
R Grant
RG
Department of Psychiatry, University of North Carolina at Chapel Hill, Campus Box 7160, Chapel Hill, North Carolina 27599-7160, USA. Grant_Steen@med.unc.edu
Mull
Courtney
C
McClure
Robert
R
Hamer
Robert M
RM
Lieberman
Jeffrey A
JA
D000293:Adolescent; D000328:Adult; D001921:Brain / Q000473:pathology*; D002552:Cerebral Ventricles / Q000473:pathology; D005260:Female; D006624:Hippocampus / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D012107:Research Design; D012559:Schizophrenia / Q000473:pathology*