Brain Changes Seen After First-Episode Psychosis in Teens

Increased gray matter volume loss and frontal lobe CSF volume found in adolescents with schizophrenia

MONDAY, Jan. 9 (HealthDay News) -- Children and adolescents with schizophrenia have significantly greater brain gray matter (GM) volume loss and increased frontal lobe cerebrospinal fluid (CSF) volume compared with adolescents without a diagnosis of psychosis, according to a study published in the January issue of the Archives of General Psychiatry.

Celso Arango, M.D., Ph.D., of the Hospital General Universitario Gregorio Marañón in Madrid, Spain, and colleagues conducted a prospective, multicenter study to evaluate the progression of brain changes in first-episode, early-onset psychosis in 110 patients with schizophrenia, bipolar disorder, or other psychoses, and 98 matched controls. Magnetic resonance imaging techniques were used to evaluate the brain GM volume and CSF volume in the total brain and the frontal, parietal, and temporal lobes of adolescent patients. The association of brain changes with diagnosis and prognosis at two years was evaluated.

The researchers found that, during the two-year follow-up, frontal lobe GM volume was significantly reduced, and left frontal lobe CSF volume was significantly increased in those with schizophrenia, compared with matched controls. Patients with schizophrenia also had significantly different total GM volume and left parietal GM volume compared with controls. There were no significant differences seen in adolescents with bipolar disease. An increase in the number of weeks of hospitalization was associated with a greater left frontal GM volume loss, and negative symptom severity was associated with CSF increase in patients with schizophrenia.

"One or more active pathophysiologic processes seem to be occurring in the brains of children and adolescents after a first psychotic episode, especially in those with schizophrenia," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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