Progressive symptom-associated prefrontal volume loss occurs in first-episode schizophrenia but not in affective psychosis
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Although smaller gray matter volumes (GMV) in the prefrontal cortex (PFC) in schizophrenia and bipolar disorder have been reported cross-sectionally, there are, to our knowledge, no reports of longitudinal comparisons using manually drawn, gyrally based ROI, and their associations with symptoms. The object of this study was to determine whether first-episode schizophrenia (FESZ) and first-episode affective psychosis (FEAFF) patients show initial and progressive PFC GMV reduction in bilateral frontal pole, superior frontal gyrus (SFG), middle frontal gyrus (MFG), and inferior frontal gyrus (IFG) and examine their symptom associations. Twenty-one FESZ, 24 FEAFF and 23 healthy control subjects (HC) underwent 1.5T MRI with follow-up imaging on the same scanner ~ 1.5 years later. Groups were strikingly different in progressive GMV loss. FESZ showed significant progressive GMV loss in the left SFG, bilateral MFG, and bilateral IFG. In addition, left MFG and/or IFG GMV loss was associated with worsening of withdrawal–retardation and total BPRS symptoms scores. In contrast, FEAFF showed no significant difference in GMV compared with HC, either cross-sectionally or longitudinally. Of note, FreeSurfer run on the same images showed no significant changes longitudinally.
KeywordsFirst-episode schizophrenia First-episode affective psychosis Magnetic resonance imaging (MRI) Prefrontal cortex Longitudinal follow-up
This study was supported by Dept. of Veterans Affairs Medical Research Awards (Schizophrenia Center, Merit Awards to RW McCarley and ME Shenton) and by grants K02 MH 01110 and R01MH50747 (to ME Shenton), R01MH40799 and R01 MH 052807 (to RW McCarley), CIDAR P50MH080272 (to RW McCarley and ME Shenton), and R01 MH58704 (to DF Salisbury) from the National Institute of Mental Health and grants from the MIND (Mental Illness and Neuroscience Discovery) Foundation (to RW McCarley) and NARSAD (to DF Salisbury).
Compliance with ethical standards
Conflict of interest
Authors have no actual or potential conflicts of interest.
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