title: Cortical morphology of adolescents with bipolar disorder and with schizophrenia.
abstract: BACKGROUND
  Recent evidence points to overlapping decreases in cortical thickness and gyrification in the frontal lobe of patients with adult-onset schizophrenia and bipolar disorder with psychotic symptoms, but it is not clear if these findings generalize to patients with a disease onset during adolescence and what may be the mechanisms underlying a decrease in gyrification.
  
  
  METHODS
  This study analyzed cortical morphology using surface-based morphometry in 92 subjects (age range 11-18 years, 52 healthy controls and 40 adolescents with early-onset first-episode psychosis diagnosed with schizophrenia (n=20) or bipolar disorder with psychotic symptoms (n=20) based on a two year clinical follow up). Average lobar cortical thickness, surface area, gyrification index (GI) and sulcal width were compared between groups, and the relationship between the GI and sulcal width was assessed in the patient group.
  
  
  RESULTS
  Both patients groups showed decreased cortical thickness and increased sulcal width in the frontal cortex when compared to healthy controls. The schizophrenia subgroup also had increased sulcal width in all other lobes. In the frontal cortex of the combined patient group sulcal width was negatively correlated (r=-0.58, p<0.001) with the GI.
  
  
  CONCLUSIONS
  In adolescents with schizophrenia and bipolar disorder with psychotic symptoms there is cortical thinning, decreased GI and increased sulcal width of the frontal cortex present at the time of the first psychotic episode. Decreased frontal GI is associated with the widening of the frontal sulci which may reduce sulcal surface area. These results suggest that abnormal growth (or more pronounced shrinkage during adolescence) of the frontal cortex represents a shared endophenotype for psychosis.
authors.affiliation: Instituto de Investigación Sanitaria Gregorio Marañón, Dr. Esquerdo, 46, 28007 Madrid, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Dr. Esquerdo, 46, 28007 Madrid, Spain; Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Dr. Esquerdo, 46, 28007 Madrid, Spain; Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. Electronic address: joost.janssen76@gmail.com.
authors.forename: Joost
authors.initials: J
authors.lastname: Janssen
authors.affiliation: Instituto de Investigación Sanitaria Gregorio Marañón, Dr. Esquerdo, 46, 28007 Madrid, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Dr. Esquerdo, 46, 28007 Madrid, Spain; Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Avda. de la Universidad, 30, 28911 Leganés, Madrid, Spain.
authors.forename: Yasser
authors.initials: Y
authors.lastname: Alemán-Gómez
authors.affiliation: Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
authors.forename: Hugo
authors.initials: H
authors.lastname: Schnack
authors.affiliation: Behavioral Neurosciences Program, McGill University, N8-15 Stewart Biological Sciences Building, 1205 Docteur Penfield Avenue, Montreal QC H3A 1B1, Canada.
authors.forename: Evan
authors.initials: E
authors.lastname: Balaban
authors.affiliation: Instituto de Investigación Sanitaria Gregorio Marañón, Dr. Esquerdo, 46, 28007 Madrid, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Dr. Esquerdo, 46, 28007 Madrid, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College London, 16 de Crespigny Park, London SE5 8AF, UK.
authors.forename: Laura
authors.initials: L
authors.lastname: Pina-Camacho
authors.affiliation: Instituto de Investigación Sanitaria Gregorio Marañón, Dr. Esquerdo, 46, 28007 Madrid, Spain.
authors.forename: Fidel
authors.initials: F
authors.lastname: Alfaro-Almagro
authors.affiliation: Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Dr. Esquerdo, 46, 28007 Madrid, Spain; Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic of Neurosciences, Hospital Clínic Universitari of Barcelona, Villarroel, 170, Barcelona 08036, Spain; Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Casanovas, 143, Barcelona 08036, Spain.
authors.forename: Josefina
authors.initials: J
authors.lastname: Castro-Fornieles
authors.affiliation: Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Dr. Esquerdo, 46, 28007 Madrid, Spain; Child and Adolescent Mental Health Unit, Department of Psychiatry and Psychology, Hospital Universitario Marqués de Valdecilla, Avda. Valdecilla nº 25, 39008 Santander, Spain.
authors.forename: Soraya
authors.initials: S
authors.lastname: Otero
authors.affiliation: Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Dr. Esquerdo, 46, 28007 Madrid, Spain; Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic of Neurosciences, Hospital Clínic Universitari of Barcelona, Villarroel, 170, Barcelona 08036, Spain.
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Baeza
authors.affiliation: Instituto de Investigación Sanitaria Gregorio Marañón, Dr. Esquerdo, 46, 28007 Madrid, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Dr. Esquerdo, 46, 28007 Madrid, Spain; Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Dr. Esquerdo, 46, 28007 Madrid, Spain.
authors.forename: Dolores
authors.initials: D
authors.lastname: Moreno
authors.affiliation: Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Dr. Esquerdo, 46, 28007 Madrid, Spain; Magnetic Resonance Image Core Facility, IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), Barcelona, Spain; Image Diagnostic Center, Hospital Clínic, Barcelona, Spain.
authors.forename: Nuria
authors.initials: N
authors.lastname: Bargalló
authors.affiliation: Instituto de Investigación Sanitaria Gregorio Marañón, Dr. Esquerdo, 46, 28007 Madrid, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Dr. Esquerdo, 46, 28007 Madrid, Spain; Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Dr. Esquerdo, 46, 28007 Madrid, Spain.
authors.forename: Mara
authors.initials: M
authors.lastname: Parellada
authors.affiliation: Instituto de Investigación Sanitaria Gregorio Marañón, Dr. Esquerdo, 46, 28007 Madrid, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Dr. Esquerdo, 46, 28007 Madrid, Spain; Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Dr. Esquerdo, 46, 28007 Madrid, Spain.
authors.forename: Celso
authors.initials: C
authors.lastname: Arango
authors.affiliation: Instituto de Investigación Sanitaria Gregorio Marañón, Dr. Esquerdo, 46, 28007 Madrid, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Dr. Esquerdo, 46, 28007 Madrid, Spain; Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Avda. de la Universidad, 30, 28911 Leganés, Madrid, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Desco
mesh_terms: D000293:Adolescent; D001714:Bipolar Disorder / Q000188:drug therapy / Q000473:pathology*; D002540:Cerebral Cortex / Q000473:pathology*; D002648:Child; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D009929:Organ Size; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000188:drug therapy / Q000473:pathology*
keywords: Adolescent-onset psychosis; Bipolar disorder; Brain development; Cortex; Cortical thickness; Gyrification; Psychosis; Schizophrenia; Sulcal width