title: Volumetric abnormalities predating the onset of schizophrenia and affective psychoses: an MRI study in subjects at ultrahigh risk of psychosis.
abstract: It remains unclear whether brain structural abnormalities observed before the onset of psychosis are specific to schizophrenia or are common to all psychotic disorders. This study aimed to measure regional gray matter volume prior to the onset of schizophreniform and of affective psychoses. We investigated 102 subjects at ultrahigh risk (UHR) of developing psychosis recruited from the Personal Assessment and Crisis Evaluation Clinic in Melbourne, Australia. Twenty-eight of these subjects developed psychosis subsequent to scanning: 19 schizophrenia, 7 affective psychoses, and 2 other psychoses. We examined regional gray matter volume using 1.5 mm thick, coronal, 1.5 Tesla magnetic resonance imaging and voxel-based morphometry methods of image analysis. Subjects were scanned at presentation and were followed up clinically for a minimum of 12 months, to detect later transition to psychosis. We found that both groups of subjects who subsequently developed psychosis (schizophrenia and affective psychosis) showed reductions in the frontal cortex relative to UHR subjects who did not develop psychosis. The subgroup that subsequently developed schizophrenia also showed smaller volumes in the parietal cortex and, at trend level, in the temporal cortex, whereas those who developed an affective psychosis had significantly smaller subgenual cingulate volumes. These preliminary findings suggest that volumetric abnormalities in UHR individuals developing schizophrenia vs affective psychoses comprise a combination of features that predate both disorders and others that may be specific to the nature of the subsequent disorder.
authors.affiliation: Department of Psychosis Studies, Section of Early Psychosis, Institute of Psychiatry, King's College London, De Crespigny Park, London, UK. paola.dazzan@kcl.ac.uk
authors.forename: Paola
authors.initials: P
authors.lastname: Dazzan
authors.forename: Bridget
authors.initials: B
authors.lastname: Soulsby
authors.forename: Andrea
authors.initials: A
authors.lastname: Mechelli
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Wood
authors.forename: Dennis
authors.initials: D
authors.lastname: Velakoulis
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Phillips
authors.forename: Alison R
authors.initials: AR
authors.lastname: Yung
authors.forename: Xavier
authors.initials: X
authors.lastname: Chitnis
authors.forename: Ashleigh
authors.initials: A
authors.lastname: Lin
authors.forename: Robin M
authors.initials: RM
authors.lastname: Murray
authors.forename: Patrick D
authors.initials: PD
authors.lastname: McGorry
authors.forename: Philip K
authors.initials: PK
authors.lastname: McGuire
authors.forename: Christos
authors.initials: C
authors.lastname: Pantelis
mesh_terms: D000293:Adolescent; D000328:Adult; D000679:Amygdala / Q000473:pathology; D001921:Brain / Q000473:pathology*; D001931:Brain Mapping; D002540:Cerebral Cortex / Q000473:pathology; D018450:Disease Progression; D005260:Female; D006179:Gyrus Cinguli / Q000473:pathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D021621:Imaging, Three-Dimensional; D007406:Interview, Psychological; D008279:Magnetic Resonance Imaging; D008297:Male; D009929:Organ Size / Q000502:physiology; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000503:physiopathology* / Q000523:psychology; D012307:Risk Factors; D012559:Schizophrenia / Q000175:diagnosis* / Q000503:physiopathology*; D012565:Schizophrenic Psychology; D012569:Schizotypal Personality Disorder / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D055815:Young Adult