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Progressive brain change in schizophrenia: a prospective longitudinal study of first-episode schizophrenia
Journal article   Peer reviewed

Progressive brain change in schizophrenia: a prospective longitudinal study of first-episode schizophrenia

Nancy C Andreasen, Peg Nopoulos, Vincent Magnotta, Ronald Pierson, Steven Ziebell and Beng-Choon Ho
Biological psychiatry (1969), Vol.70(7), pp.672-679
10/01/2011
DOI: 10.1016/j.biopsych.2011.05.017
PMCID: PMC3496792
PMID: 21784414

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Abstract

Schizophrenia has a characteristic onset during adolescence or young adulthood but also tends to persist throughout life. Structural magnetic resonance studies indicate that brain abnormalities are present at onset, but longitudinal studies to assess neuroprogression have been limited by small samples and short or infrequent follow-up intervals. The Iowa Longitudinal Study is a prospective study of 542 first-episode patients who have been followed up to 18 years. In this report, we focus on those patients (n = 202) and control subjects (n = 125) for whom we have adequate structural magnetic resonance data (n = 952 scans) to provide a relatively definitive determination of whether progressive brain change occurs over a time interval of up to 15 years after intake. A repeated-measures analysis showed significant age-by-group interaction main effects that represent a significant decrease in multiple gray matter regions (total cerebral, frontal, thalamus), multiple white matter regions (total cerebral, frontal, temporal, parietal), and a corresponding increase in cerebrospinal fluid (lateral ventricles and frontal, temporal, and parietal sulci). These changes were most severe during the early years after onset. They occur at severe levels only in a subset of patients. They are correlated with cognitive impairment but only weakly with other clinical measures. Progressive brain change occurs in schizophrenia, affects both gray matter and white matter, is most severe during the early stages of the illness, and occurs only in a subset of patients. Measuring severity of progressive brain change offers a promising new avenue for phenotype definition in genetic studies of schizophrenia.
Neuroimaging - methods Lateral Ventricles - pathology Prospective Studies Humans Atrophy - pathology Cognition Disorders - pathology Magnetic Resonance Imaging - methods Male Schizophrenia - complications Schizophrenia - pathology Neuroimaging - statistics & numerical data Schizophrenic Psychology Case-Control Studies Disease Progression Cognition Disorders - complications Neuropsychological Tests - statistics & numerical data Schizophrenia - diagnosis Magnetic Resonance Imaging - statistics & numerical data Brain - pathology Adult Female Longitudinal Studies

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