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Gender effects on brain changes in early-onset psychosis

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Abstract

Progressive loss of cortical gray matter (GM) and increase of cerebrospinal fluid (CSF) have been reported in early-onset psychosis (EOP). EOP typically begins during adolescence, a time when developmental brain trajectories differ by gender. This study aimed to determine gender differences in progression of brain changes in this population. A sample of 61 (21 females) adolescents with a first psychotic episode and a matched sample of 70 (23 females) controls underwent both baseline and 2-year follow-up anatomical brain imaging assessments. Regional GM and CSF volumes were obtained using automated methods based on the Talairach’s proportional grid system. At baseline, only male patients showed a clear pattern of alterations in the frontal lobe relative to controls (smaller GM and larger CSF volumes). However, parallel longitudinal changes for male and female patients relative to controls were observed, resulting in a common pattern of brain changes across both genders: rate of left frontal lobe GM volume loss was larger in male (−3.8 %) and female patients (−4.2 %) than in controls (−0.7 % males; −0.4 % females). The reverse was found for the CSF volume in the left frontal lobe. While the GM and CSF volumes of females with EOP appear to be within the normal range at initial illness onset, our results point to a similar trajectory of increased/accelerated brain changes in both male and female patients with EOP. The pattern of progression of brain changes in psychosis appears to be independent of gender or structural alterations on appearance of psychotic symptoms.

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Acknowledgments

We thank Jose de Arriba of the Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, CIBERSAM, Madrid, Spain for data management. In memoriam: Santiago Reig, Ph.D. (1958–2011). We thank Dr. Reig for his statistical guidance, mentorship and outstanding contributions, not only to the development of this study but also to the field of neuroimaging studies in early-onset psychosis.

Conflict of interest

This work was supported by the Spanish Ministry of Economy and Competitiveness. Instituto de Salud Carlos III, CIBERSAM, RETICS RD06/0011 (REM-TAP Network), Fundación Alicia Koplowitz, Fundación Mutua Madrileña, by Grants PI02/1248, PI05/0678, PI09/01442, PI12/1303, G03/032, Regional Government (S2010/BMD-2422 AGES) and by the European Union Structural Funds (Madrid, Spain). This work was partially supported by Spain’s Ministry of Science and Innovation through CDTI’s CENIT Program (AMIT Project). Dr. Rapado-Castro has received a Health Research Sara Borrell Fellowship from the Spanish Ministry of Economy and Competitiveness, an Alicia Koplowitz Grant for Short-Term Placements from the Alicia Koplowitz Foundation and an IiSGM Fellowship Award for Short-term Placements from the Health Research Institute from the Hospital Gregorio Marañón (IiSGM) (Madrid, Spain). Dr. Rapado-Castro has also received grant support from the Fundación Alicia Koplowitz. Dr. Bartholomeusz has received a National Health and Medical Research Council (NHMRC) Australian-based Clinical Research Fellowship and a John and Betty Lynch Fellowship from the Department of Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne. Dr. González-Pinto is employed by the University of the Basque Country and has been a consultant for the Ministry of Science of Spain and the Basque Government. Dr. González-Pinto also gives conferences, acts as consultant to or receives grants from Lilly, Janssen, MSD, Lundbek, AstraZeneca, Almirall, Sanofi Aventis, BMS, Novartis and Pfizer. Dr. Baeza has received support from Otsuka for attending a conference. Dr. Moreno has served as a consultant to AstraZeneca, Otsuka, Bristol-Myers Squibb and Janssen. Dr. Moreno has also received grant support from the Fundación Alicia Koplowitz, Instituto de Salud Carlos III and European Union Structural Funds. Professor Pantelis has received a NHMRC Australian-based Senior Principal Research Fellowship (ID: 628386), NARSAD Distinguished Investigator Award (US; Grant ID: 18722), and NHMRC Program Grant (ID: 566529); he has received grant support from Janssen-Cilag, Eli Lilly, Hospira (Mayne), Astra Zeneca and has provided consultancy to Janssen-Cilag, Eli Lilly, Hospira (Mayne), Astra Zeneca, Pfizer, Schering Plough, Lundbeck. He has undertaken investigator initiated studies supported by Eli Lilly, Hospira, Janssen Cilag and Astra Zeneca. Dr. Arango. has been a consultant to or has received honoraria or grants from Abbot, AMGEN, AstraZeneca, Bristol-Myers Squibb, Caja Navarra, CIBERSAM, Fundación Alicia Koplowitz, Instituto de Salud Carlos III, Janssen Cilag, Lundbeck, Merck, Ministerio de Ciencia e Innovación, Ministerio de Sanidad, Ministerio de Economía y Competitividad, Mutua Madrileña, Otsuka, Pfizer, Roche, Servier, Shire, Takeda and Schering Plough. The rest of the authors declare no conflicts of interest.

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Authors and Affiliations

  1. Child and Adolescent Psychiatry Department, CIBERSAM, Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, Madrid, Spain

    Marta Rapado-Castro, Carmen Moreno, Joost Janssen & Celso Arango

  2. Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, 161 Barry Street, Carlton South, VIC, 3053, Australia

    Marta Rapado-Castro, Cali F. Bartholomeusz & Christos Pantelis

  3. Child Psychiatry and Psychology Department, Neurosciences Institute, Hospital Clinic de Barcelona, IDIBAPS, SGR-1119, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Barcelona, Spain

    Josefina Castro-Fornieles & Inmaculada Baeza

  4. Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain

    Josefina Castro-Fornieles & Inmaculada Baeza

  5. Hospital Santiago Apóstol de Vitoria, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Kronikgune, EHU-UPV, Vitoria, Spain

    Ana González-Pinto

  6. Child Psychiatry Unit, Hospital Universitario Marqués de Valdecilla, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Santander, Spain

    Soraya Otero

  7. Psychiatry and Psychology Department, Hospital Infantil Universitario Niño Jesús, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain

    Montserrat Graell

  8. Image Diagnostic Center, Hospital Clinic de Barcelona, IDIBAPS, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Barcelona, Spain

    Nuria Bargalló

  9. Department of Bioengineering and Aerospatial Engineering, University Carlos III de Madrid, Madrid, Spain

    Manuel Desco

  10. Medicina y Cirugía Experimental, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, CIBERSAM, Madrid, Spain

    Joost Janssen & Manuel Desco

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  1. Marta Rapado-Castro
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  2. Cali F. Bartholomeusz
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  3. Josefina Castro-Fornieles
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  6. Inmaculada Baeza
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  7. Carmen Moreno
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  8. Montserrat Graell
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  10. Nuria Bargalló
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  12. Manuel Desco
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  13. Celso Arango
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Correspondence to Marta Rapado-Castro.

Additional information

Partial results of this work were presented as a poster at the 2nd Biennial Schizophrenia International Research Conference, April 12, 2010 in Florence, Italy. The abstract was published in Schizophrenia Research, doi:10.1016/j.schres.2010.02.605. This work was presented as poster at the 3rd Schizophrenia International Research Society Conference “Schizophrenia: The Globalization of research”. Florence, Italy. The abstract was published in Schizophrenia Research, 136 (Supplement 1) pp. 372–373. ISSN 0920-9964.

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Rapado-Castro, M., Bartholomeusz, C.F., Castro-Fornieles, J. et al. Gender effects on brain changes in early-onset psychosis. Eur Child Adolesc Psychiatry 24, 1193–1205 (2015). https://doi.org/10.1007/s00787-014-0669-x

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