Internal capsule size associated with outcome in first-episode schizophrenia.
Subtle structural brain abnormalities are an established finding in first-episode psychosis. Nevertheless their relationship to the clinical course of schizophrenia is controversially discussed. In a multicentre study 45 first-episode schizophrenia patients (FE-SZ) underwent standardized MRI scanning and were followed up to 1 year. In 32 FE-SZ volumetric measurement of three regions of interests (ROIs) potentially associated with disease course, hippocampus, lateral ventricle and the anterior limb of the internal capsule (ALIC) could be performed. The subgroups of FE-SZ with good (12 patients) and poor outcome (11 patients), defined by a clinically relevant change of the PANSS score, were compared with regard to these volumetric measures. Multivariate analysis of covariance revealed a significant reduced maximal cross sectional area of the left ALIC in FE-SZ with clinically relevant deterioration compared to those with stable psychopathology. There were no differences in the other selected ROIs between the two subgroups. In conclusion, reduced maximal area of ALIC, which can be interpreted as a disturbance of fronto-thalamic connectivity, is associated with poor outcome during the 1 year course of first-episode schizophrenia.
Wobrock
Thomas
T
Department of Psychiatry and Psychotherapy, Georg-August University Göttingen, Göttingen, Germany. twobroc@gwdg.de
Gruber
Oliver
O
Schneider-Axmann
Thomas
T
Wölwer
Wolfgang
W
Gaebel
Wolfgang
W
Riesbeck
Mathias
M
Maier
Wolfgang
W
Klosterkötter
Joachim
J
Schneider
Frank
F
Buchkremer
Gerd
G
Möller
Hans-Jürgen
HJ
Schmitt
Andrea
A
Bender
Stefan
S
Schlösser
Ralf
R
Falkai
Peter
P
D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006220:Haloperidol / Q000627:therapeutic use; D006624:Hippocampus / Q000473:pathology*; D006801:Humans; D020772:Internal Capsule / Q000473:pathology*; D020547:Lateral Ventricles / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011569:Psychiatric Status Rating Scales; D018967:Risperidone / Q000627:therapeutic use; D012559:Schizophrenia / Q000188:drug therapy / Q000473:pathology*; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult
D014150:Antipsychotic Agents; D006220:Haloperidol; D018967:Risperidone