title: Brain structure in people at ultra-high risk of psychosis, patients with first-episode schizophrenia, and healthy controls: a VBM study.
abstract: Early intervention research in schizophrenia has suggested that brain structural alterations might be present in subjects at high risk of developing psychosis. The heterogeneity of regional effects of these changes, which is established in schizophrenia, however, has not been explored in prodromal or high-risk populations. We used high-resolution MRI and voxel-based morphometry (VBM8) to analyze grey matter differences in 43 ultra high-risk subjects for psychosis (meeting ARMS criteria, identified through CAARMS interviews), 24 antipsychotic-naïve first-episode schizophrenia patients and 49 healthy controls (groups matched for age and gender). Compared to healthy controls, resp., first-episode schizophrenia patients had reduced regional grey matter in left prefrontal, insula, right parietal and left temporal cortices, while the high-risk group showed reductions in right middle temporal and left anterior frontal cortices. When dividing the ultra-high-risk group in those with a genetic risk vs. those with attenuated psychotic symptoms, the former showed left anterior frontal, right caudate, as well as a smaller right hippocampus, and amygdala reduction, while the latter subgroup showed right middle temporal cortical reductions (each compared to healthy controls). Our findings in a clinical psychosis high-risk cohort demonstrate variability of brain structural changes according to subgroup and background of elevated risk, suggesting frontal and possibly also hippocampal/amygdala changes in individuals with genetic susceptibility. Heterogeneity of structural brain changes (as seen in schizophrenia) appears evident even at high-risk stage, prior to potential onset of psychosis.
authors.affiliation: Department of Psychiatry and Psychotherapy, Jena University Hospital, 07743 Jena, Germany. Electronic address: igor.nenadic@uni-jena.de.
authors.forename: Igor
authors.initials: I
authors.lastname: Nenadic
authors.affiliation: Department of Psychiatry and Psychotherapy, Jena University Hospital, 07743 Jena, Germany.
authors.forename: Maren
authors.initials: M
authors.lastname: Dietzek
authors.affiliation: Department of Psychiatry and Psychotherapy, Jena University Hospital, 07743 Jena, Germany.
authors.forename: Nils
authors.initials: N
authors.lastname: Schönfeld
authors.affiliation: Department of Psychiatry and Psychotherapy, Jena University Hospital, 07743 Jena, Germany.
authors.forename: Carsten
authors.initials: C
authors.lastname: Lorenz
authors.affiliation: Medical Physics Group, Institute for Diagnostic and Interventional Radiology (IDIR), Jena University Hospital, 07743 Jena, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Gussew
authors.affiliation: Medical Physics Group, Institute for Diagnostic and Interventional Radiology (IDIR), Jena University Hospital, 07743 Jena, Germany.
authors.forename: Jürgen R
authors.initials: JR
authors.lastname: Reichenbach
authors.affiliation: Department of Psychiatry and Psychotherapy, Jena University Hospital, 07743 Jena, Germany.
authors.forename: Heinrich
authors.initials: H
authors.lastname: Sauer
authors.affiliation: Department of Psychiatry and Psychotherapy, Jena University Hospital, 07743 Jena, Germany; Department of Neurology, Jena University Hospital, 07743 Jena, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Gaser
authors.affiliation: Department of Psychiatry and Psychotherapy, Jena University Hospital, 07743 Jena, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Smesny
mesh_terms: D000328:Adult; D001921:Brain / Q000473:pathology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D062706:Prodromal Symptoms; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000473:pathology*; D012307:Risk Factors; D012559:Schizophrenia / Q000473:pathology* / Q000503:physiopathology; D012565:Schizophrenic Psychology; D055815:Young Adult
keywords: At-risk mental state (ARMS); Magnetic resonance imaging (MRI); Psychosis; Schizophrenia; Ultra high-risk (UHR); Voxel-based morphometry (VBM)