Teenagers who have been diagnosed with schizophrenia or similar psychotic disorders sometimes show a greater decrease in gray matter volume compared to healthy teens, according to new research.
The new study also found that adolescents with schizophrenia showed an increase in cerebrospinal fluid in the frontal lobe of their brain.
“Progressive loss of brain gray matter has been reported in childhood-onset schizophrenia,” the authors note in the new study. “However, it is uncertain whether these changes are shared by pediatric patients with different psychoses.”
The study was conducted by Celso Arango, M.D., Ph.D., of the Hospital General Universitario Gregorio Marañón, Madrid, Spain, and colleagues, and was designed to examine the progression of brain changes in first-episode early-onset psychosis in teens. The research also wanted to look at the relationship to diagnosis and prognosis after two years.
The patients in the study were drawn from six child and adolescent psychiatric units in Spain.
The authors performed magnetic resonance imaging (MRI) of the brain for 61 patients (25 diagnosed with schizophrenia, 16 with bipolar disorder and 20 with other psychoses) and 70 healthy control participants. MRI scans were conducted at the onset of the study, and then again after two years.
Compared with control patients, those diagnosed with schizophrenia showed greater gray matter volume loss in the frontal lobe during the two-year follow-up. Patients with schizophrenia also showed cerebrospinal fluid increase in the left frontal lobe.
Additionally, changes for total brain gray matter and left parietal gray matter were significantly different in patients with schizophrenia compared with patients in the control group.
Among patients with schizophrenia, progressive brain volume changes in certain areas were related to markers of poorer prognosis, such as more weeks of hospitalization during follow-up and less improvement in negative symptoms.
Greater left frontal gray matter volume loss was related to more weeks of hospitalization whereas severity of negative symptoms correlated with cerebrospinal fluid increase in patients with schizophrenia.
The study could not determine whether the brain changes were a result of the schizophrenia, or whether schizophrenia was the result of the brain changes.
The authors did not find any significant changes in patients with bipolar disorder compared to control patients, and longitudinal brain changes in the control group were consistent with the expected pattern described for healthy adolescents.
“In conclusion, we found progression of gray matter volume loss after a two-year follow-up in patients who ended up with a diagnosis of schizophrenia but not bipolar disease compared with healthy controls,” the authors write.
“Some of these pathophysiologic processes seem to be markers of poorer prognosis. To develop therapeutic strategies to counteract these pathologic progressive brain changes, future studies should focus on their neurobiological underpinnings.”
The new study appears in the January 2012 issue of the journal Archives of General Psychiatry.