Childhood onset schizophrenia: cortical brain abnormalities as young adults.
BACKGROUND
Childhood onset schizophrenia (COS) is a rare but severe form of the adult onset disorder. While structural brain imaging studies show robust, widespread, and progressive gray matter loss in COS during adolescence, there have been no longitudinal studies of sufficient duration to examine comparability with the more common adult onset illness.


METHODS
Neuro-anatomic magnetic resonance scans were obtained prospectively from ages 7 through 26 in 70 children diagnosed with COS and age and sex matched healthy controls. Cortical thickness was measured at 40,962 points across the cerebral hemispheres using a novel, fully automated, validated method. Patterns of patient-control differences in cortical development were compared over a 19-year period.


RESULTS
Throughout the age range, the COS group had significantly smaller mean cortical thickness compared to controls. However, the COS brain developmental trajectory appeared to normalize in posterior (parietal) regions, and remained divergent in the anterior regions (frontal and temporal) regions, and the pattern of loss became more like that seen in adults.


CONCLUSIONS
Cortical thickness loss in COS appears to localize with age to prefrontal and temporal regions that are seen for both medication naïve and medicated adult onset patients.
Greenstein
Deanna
D
Child Psychiatry Branch, NIMH/NIH, Bethesda, MD 20892, USA. greenstd@mail.nih.gov
Lerch
Jason
J
Shaw
Philip
P
Clasen
Liv
L
Giedd
Jay
J
Gochman
Peter
P
Rapoport
Judith
J
Gogtay
Nitin
N
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D014150:Antipsychotic Agents / Q000627:therapeutic use; D002540:Cerebral Cortex / Q000002:abnormalities*; D002648:Child; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology; D003710:Demography; D005625:Frontal Lobe / Q000002:abnormalities; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests; D010296:Parietal Lobe / Q000002:abnormalities; D011446:Prospective Studies; D012561:Schizophrenia, Childhood / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D012720:Severity of Illness Index
D014150:Antipsychotic Agents