title: What determines continuing grey matter changes in first-episode schizophrenia and affective psychosis?
abstract: BACKGROUND
  Magnetic resonance imaging (MRI) studies have shown that brain abnormalities in psychosis might be progressive during the first years of illness. We sought to determine whether first-episode psychosis (FEP) subjects show progressive regional grey matter (GM) changes compared with controls, and whether those changes are associated with diagnosis, illness course or antipsychotic (AP) use.
  
  
  METHODS
  Thirty-two subjects with first-episode schizophrenia-spectrum disorders (FESZ), 24 patients with first-episode affective psychoses (FEAP) and 34 controls recruited using a population-based design underwent structural MRI scanning at baseline and at a 5-year follow-up. Regional GM volumes were assessed with voxel-based morphometry (VBM). Patients were treated at community settings, and about half of them remained mainly untreated.
  
  
  RESULTS
  No significant progressive changes in GM regional volumes were observed in either the FESZ or FEAP group overall. However, FESZ subjects with a non-remitting course showed GM decrements in the left superior temporal gyrus (STG) and insula relative to remitted FESZ subjects. Non-remitted FEAP subjects exhibited a GM decrease in the dorsolateral prefrontal cortex (DLPFC) bilaterally in comparison to remitted FEAP subjects. Among FESZ subjects, AP use was associated with regional GM decrements in the right insula and increments in the cerebellum.
  
  
  CONCLUSIONS
  Our results suggest that the progression of brain abnormalities in FEP subjects is restricted to those with a poor outcome and differs between diagnosis subgroups. AP intake is associated with a different pattern of GM reductions over time.
authors.affiliation: Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, Faculty of Medicine,University of São Paulo,Brazil.
authors.forename: P G P
authors.initials: PG
authors.lastname: Rosa
authors.affiliation: Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, Faculty of Medicine,University of São Paulo,Brazil.
authors.forename: M V
authors.initials: MV
authors.lastname: Zanetti
authors.affiliation: Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, Faculty of Medicine,University of São Paulo,Brazil.
authors.forename: F L S
authors.initials: FL
authors.lastname: Duran
authors.affiliation: Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, Faculty of Medicine,University of São Paulo,Brazil.
authors.forename: L C
authors.initials: LC
authors.lastname: Santos
authors.affiliation: Department of Preventive Medicine, Faculty of Medicine,University of São Paulo,Brazil.
authors.forename: P R
authors.initials: PR
authors.lastname: Menezes
authors.affiliation: Laboratory of Psychopharmacology and Clinical Psychophysiology (LIM-23), Faculty of Medicine,Institute of Psychiatry, University of São Paulo,Brazil.
authors.forename: M
authors.initials: M
authors.lastname: Scazufca
authors.affiliation: Department of Psychosis Studies,Institute of Psychiatry, King's College London,UK.
authors.forename: R M
authors.initials: RM
authors.lastname: Murray
authors.affiliation: Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, Faculty of Medicine,University of São Paulo,Brazil.
authors.forename: G F
authors.initials: GF
authors.lastname: Busatto
authors.affiliation: Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, Faculty of Medicine,University of São Paulo,Brazil.
authors.forename: M S
authors.initials: MS
authors.lastname: Schaufelberger
mesh_terms: D000328:Adult; D000341:Affective Disorders, Psychotic / Q000473:pathology*; D002540:Cerebral Cortex / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D066128:Gray Matter / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D012559:Schizophrenia / Q000473:pathology*
keywords: voxel-based morphometry