Three-year longitudinal population-based volumetric MRI study in first-episode schizophrenia spectrum patients.
BACKGROUND
Schizophrenia is a chronic brain disorder associated with structural brain abnormalities already present at the onset of the illness. Whether these brain abnormalities might progress over time is still under debate.


METHODS
The aim of this study was to investigate likely progressive brain volume changes in schizophrenia during the first 3 years after initiating antipsychotic treatment. The study included 109 patients with a schizophrenia spectrum disorder and a control group of 76 healthy subjects. Subjects received detailed clinical and cognitive assessment and structural magnetic resonance imaging (MRI) at regular time points during a 3-year follow-up period. The effects of brain changes on cognitive and clinical variables were examined along with the impact of potential confounding factors.


RESULTS
Overall, patients and healthy controls exhibited a similar pattern of brain volume changes. However, patients showed a significant lower progressive decrease in the volume of the caudate nucleus than control subjects (F 1,307.2 = 2.12, p = 0.035), with healthy subjects showing a greater reduction than patients during the follow-up period. Clinical and cognitive outcomes were not associated with progressive brain volume changes during the early years of the illness.


CONCLUSIONS
Brain volume abnormalities that have been consistently observed at the onset of non-affective psychosis may not inevitably progress, at least over the first years of the illness. Taking together with clinical and cognitive longitudinal data, our findings, showing a lack of brain deterioration in a substantial number of individuals, suggest a less pessimistic and more reassuring perception of the illness.
Marqués de Valdecilla University Hospital, IFIMAV, Santander, Spain.
R
R
Roiz-Santiáñez
Marqués de Valdecilla University Hospital, IFIMAV, Santander, Spain.
R
R
Ayesa-Arriola
Marqués de Valdecilla University Hospital, IFIMAV, Santander, Spain.
D
D
Tordesillas-Gutiérrez
Marqués de Valdecilla University Hospital, IFIMAV, Santander, Spain.
V
V
Ortiz-García de la Foz
Marqués de Valdecilla University Hospital, IFIMAV, Santander, Spain.
R
R
Pérez-Iglesias
Marqués de Valdecilla University Hospital, IFIMAV, Santander, Spain.
A
A
Pazos
Department of Neuroradiology, Marqués de Valdecilla University Hospital, Santander, Spain.
E
E
Sánchez
Marqués de Valdecilla University Hospital, IFIMAV, Santander, Spain.
B
B
Crespo-Facorro
D000328:Adult; D001921:Brain / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D012559:Schizophrenia / Q000473:pathology*