Neuroanatomical correlates of different vulnerability states for psychosis and their clinical outcomes.
BACKGROUND
Structural brain abnormalities have been described in individuals with an at-risk mental state for psychosis. However, the neuroanatomical underpinnings of the early and late at-risk mental state relative to clinical outcome remain unclear.


OBJECTIVE
To investigate grey matter volume abnormalities in participants in a putatively early or late at-risk mental state relative to their prospective clinical outcome.


METHODS
Voxel-based morphometry of magnetic resonance imaging data from 20 people with a putatively early at-risk mental state (ARMS-E group) and 26 people with a late at-risk mental state (ARMS-L group) as well as from 15 participants with at-risk mental states with subsequent disease transition (ARMS-T group) and 18 participants without subsequent disease transition (ARMS-NT group) were compared with 75 healthy volunteers.


RESULTS
Compared with healthy controls, ARMS-L participants had grey matter volume losses in frontotemporolimbic structures. Participants in the ARMS-E group showed bilateral temporolimbic alterations and subtle prefrontal abnormalities. Participants in the ARMS-T group had prefrontal alterations relative to those in the ARMS-NT group and in the healthy controls that overlapped with the findings in the ARMS-L group.


CONCLUSIONS
Brain alterations associated with the early at-risk mental state may relate to an elevated susceptibility to psychosis, whereas alterations underlying the late at-risk mental state may indicate a subsequent transition to psychosis.
Koutsouleris
Nikolaos
N
Department of Psychiatry and Psychotherapy, Luwdig-Maxmilians-University, 80336 Munich, Germany.
Schmitt
Gisela J E
GJ
Gaser
Christian
C
Bottlender
Ronald
R
Scheuerecker
Johanna
J
McGuire
Philip
P
Burgermeister
Bernhard
B
Born
Christine
C
Reiser
Maximilian
M
Möller
Hans-Jürgen
HJ
Meisenzahl
Eva M
EM
D000328:Adult; D001931:Brain Mapping / Q000379:methods; D016022:Case-Control Studies; D004198:Disease Susceptibility / Q000473:pathology; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D017397:Prefrontal Cortex / Q000473:pathology*; D011379:Prognosis; D011618:Psychotic Disorders / Q000473:pathology*; D018570:Risk Assessment; D012307:Risk Factors; D013223:Statistics as Topic; D013702:Temporal Lobe / Q000473:pathology*; D055815:Young Adult