title: Internal capsule size associated with outcome in first-episode schizophrenia.
abstract: 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.
authors.affiliation: Department of Psychiatry and Psychotherapy, Georg-August University Göttingen, Göttingen, Germany. twobroc@gwdg.de
authors.forename: Thomas
authors.initials: T
authors.lastname: Wobrock
authors.forename: Oliver
authors.initials: O
authors.lastname: Gruber
authors.forename: Thomas
authors.initials: T
authors.lastname: Schneider-Axmann
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Wölwer
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Gaebel
authors.forename: Mathias
authors.initials: M
authors.lastname: Riesbeck
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Maier
authors.forename: Joachim
authors.initials: J
authors.lastname: Klosterkötter
authors.forename: Frank
authors.initials: F
authors.lastname: Schneider
authors.forename: Gerd
authors.initials: G
authors.lastname: Buchkremer
authors.forename: Hans-Jürgen
authors.initials: HJ
authors.lastname: Möller
authors.forename: Andrea
authors.initials: A
authors.lastname: Schmitt
authors.forename: Stefan
authors.initials: S
authors.lastname: Bender
authors.forename: Ralf
authors.initials: R
authors.lastname: Schlösser
authors.forename: Peter
authors.initials: P
authors.lastname: Falkai
mesh_terms: 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
chemical_list: D014150:Antipsychotic Agents; D006220:Haloperidol; D018967:Risperidone