title: Structural neuroimaging across early-stage psychosis: Aberrations in neurobiological trajectories and implications for the staging model.
abstract: OBJECTIVE
  This review critically examines the structural neuroimaging evidence in psychotic illness, with a focus on longitudinal imaging across the first-episode psychosis and ultra-high-risk of psychosis illness stages.
  
  
  METHODS
  A thorough search of the literature involving specifically longitudinal neuroimaging in early illness stages of psychosis was conducted. The evidence supporting abnormalities in brain morphology and altered neurodevelopmental trajectories is discussed in the context of a clinical staging model.
  
  
  RESULTS
  In general, grey matter (and, to a lesser extent, white matter) declines across multiple frontal, temporal (especially superior regions), insular and parietal regions during the first episode of psychosis, which has a steeper trajectory than that of age-matched healthy counterparts. Although the ultra-high-risk of psychosis literature is considerably mixed, evidence indicates that certain volumetric structural aberrations predate psychotic illness onset (e.g. prefrontal cortex thinning), while other abnormalities present in ultra-high-risk of psychosis populations are potentially non-psychosis-specific (e.g. hippocampal volume reductions).
  
  
  CONCLUSIONS
  We highlight the advantages of longitudinal designs, discuss the implications such studies have on clinical staging and provide directions for future research.
authors.affiliation: 1 Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.|2 Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia.|3 Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia.
authors.forename: Cali F
authors.initials: CF
authors.lastname: Bartholomeusz
authors.affiliation: 3 Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia.
authors.forename: Vanessa L
authors.initials: VL
authors.lastname: Cropley
authors.affiliation: 1 Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.|2 Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia.|3 Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia.
authors.forename: Cassandra
authors.initials: C
authors.lastname: Wannan
authors.affiliation: 3 Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia.
authors.forename: Maria
authors.initials: M
authors.lastname: Di Biase
authors.affiliation: 1 Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.|2 Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia.
authors.forename: Patrick D
authors.initials: PD
authors.lastname: McGorry
authors.affiliation: 3 Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia.|4 Centre for Neural Engineering, Department of Electrical and Electronic Engineering, The University of Melbourne, Carlton South, VIC, Australia.
authors.forename: Christos
authors.initials: C
authors.lastname: Pantelis
mesh_terms: D001921:Brain / Q000000981:diagnostic imaging*; D018450:Disease Progression; D006801:Humans; D059906:Neuroimaging / Q000379:methods*; D011618:Psychotic Disorders / Q000000981:diagnostic imaging*
keywords: Neuroimaging; clinical staging; early psychosis; longitudinal trajectory; schizophrenia spectrum