Considering the magnitude of the reported changes in brain volume over time in first-episode patients it is unlikely that these changes are constant over the life-span of the schizophrenic illness. Thus, one would expect the progression in brain volume change in schizophrenia to follow a more complex trajectory over time.
Two magnetic resonance imaging brain scans were obtained over a 5-year interval of 96 schizophrenia patients and 113 healthy subjects between ages 16 to 56.
The trajectory of brain volume change differed between patients with schizophrenia and healthy individuals. Before the age of 45 years cerebral and gray matter loss and lateral ventricle increase were excessive in patients relative to controls, representing approximately the first 20 years of illness. Patients showed an excessive third ventricle volume increase over time. In addition, poor outcome patients showed more brain tissue loss during the follow-up interval than good outcome patients.
Cerebral (gray) matter volume loss in the patients was mainly characterized by the absence of the normal curved trajectory of volume change with age that was present in healthy subjects. Later in life, the degree of volume change in patients is similar to that observed with normal aging. Independently of age, larger brain volume changes appear clinically relevant.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Biological Psychiatry
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- The Comprehensive Assessment of Symptoms and History (CASH).Arch Gen Psychiatry. 1992; 49: 615-623
- Brain volume changes in first-episode schizophrenia: a 1-year follow-up study.Arch Gen Psychiatry. 2002; 59: 1002-1010
- Locally weighted regression: An approach to regression analysis by local fitting.J Am Statistical Assoc. 1988; 83: 596-610
- Automatic 3D intersubject registration of MR volumetric data in standardized Talairach space.J Comput Assist Tomogr. 1994; 18: 192-205
Commissie Farmaceutische Hulp van het College voor Zorgverzekeringen (2002): Farmacotherapeutisch Kompas [in Dutch]. Amstelveen, the Netherlands, Commissie Farmceutische Hulp van het College voor Zorgverzekeringen.
- Ventricular enlargement in poor-outcome schizophrenia.Biol Psychiatry. 1998; 43 ([see comments]): 783-793
- Follow up MRI study in first episode schizophrenia.Schizophr Res. 1991; 5: 204-206
- Cerebral ventricular change over the first 10 years after the onset of schizophrenia.Psychiatry Res. 2004; 130: 57-70
- The timing of brain morphological changes in schizophrenia and their relationship to clinical outcome [published erratum appears in Biol Psychiatry 1992 Jun 1;31 (11):1172].Biol Psychiatry. 1992; 31: 241-254
- A diagnostic interview: the schedule for affective disorders and schizophrenia.Arch Gen Psychiatry. 1978; 35: 837-844
- Brain imaging in normal and abnormal brain development: new perspectives for child psychiatry.Clin Neurosci Res. 2001; 1: 283-290
- Childhood onset schizophrenia: cortical brain abnormalities as young adults.J Child Psychol Psychiatry. 2006; 47: 1003-1012
- A follow-up magnetic resonance imaging study of schizophrenia.Arch Gen Psychiatry. 1998; 55: 145-152
- Global assessment of functioning.Psychosomatics. 1995; 36: 267-275
- The neuropathology of schizophrenia.Brain. 1999; 122: 593-624
- Meta-analysis of brain weight in schizophrenia.Schizophr Res. 2003; 64: 25-34
- Monographs on Statistics and Applied Probability 43: Generalized Additive Models.Chapman and Hall, London1990
- Progressive structural brain abnormalities and their relationship to clinical outcome: a longitudinal magnetic resonance imaging study early in schizophrenia.Arch Gen Psychiatry. 2003; 60: 585-594
- Volume changes in gray matter in patients with schizophrenia.Am J Psychiatry. 2002; 159: 244-250
- Cerebral ventricular enlargement in schizophreniform disorder does not progress.Schizophr Res. 1994; 14: 23-28
- Progressive loss of cerebellar volume in childhood-onset schizophrenia.Am J Psychiatry. 2003; 160: 128-133
- Dementia Praecox and Paraphrenia.E & S Livingstone, Edinburgh1919
- Longitudinal study of brain morphology in first episode schizophrenia.Biol Psychiatry. 2001; 49: 487-499
- Antipsychotic drug effects on brain morphology in first-episode psychosis.Arch Gen Psychiatry. 2005; 62: 361-370
- Neuroleptics in progressive structural brain abnormalities in psychiatric illness.Lancet. 1998; 352 ([letter]): 784-785
- Automatic volume measurement in schizophrenia: nonlinear or linear transformation?.Neuroimage. 1999; 9: 112
- Progressive brain volume changes and the clinical course of schizophrenia in men: a longitudinal magnetic resonance imaging study.Arch Gen Psychiatry. 2001; 58: 148-157
- A selective review of recent North American long-term followup studies of schizophrenia.Schizophr Bull. 1988; 14: 515-542
- Schizophrenia as a disorder of developmentally reduced synaptic connectivity.Arch Gen Psychiatry. 2000; 57: 637-648
- Larger brains in medication naive high-functioning subjects with pervasive developmental disorder.J Autism Dev Disord. 2004; 34: 603-613
- Structural brain imaging evidence for multiple pathological processes at different stages of brain development in schizophrenia.Schizophr Bull. 2005; 31: 672-696
- Structured Interview for DSMIV Personality: SIDP-IV.University of Iowa, Department of Psychiatry, Iowa City1995
- The Camberwell Assessment of Need: the validity and reliability of an instrument to assess the needs of people with severe mental illness.Br J Psychiatry. 1995; 167: 589-595
- A serial longitudinal quantitative MRI study of cerebral changes in first-episode schizophrenia using image segmentation and subvoxel registration.Psychiatry Res. 2001; 106: 141-150
- Progressive cortical change during adolescence in childhood-onset schizophrenia.Arch Gen Psychiatry. 1999; 56: 649-654
- The reduced neuropil hypothesis: a circuit based model of schizophrenia.Biol Psychiatry. 1999; 45: 17-25
- Progressive brain volume loss during adolescence in childhood-onset schizophrenia.Am J Psychiatry. 2003; 160: 2181-2189
- Brain volumes as predictor of outcome in recent-onset schizophrenia: a multi-center MRI study.Schizophr Res. 2003; 64: 41-52
- Stability of cerebral ventricular size from the appearance of the first psychotic symptoms to the later diagnosis of schizophrenia.Biol Psychiatry. 1994; 35: 960-962
- Neurotoxicity, neuroplasticity, and magnetic resonance imaging morphometry: what is happening in the schizophrenic brain?.Arch Gen Psychiatry. 2002; 59: 553-558
- A longitudinal study of hippocampal volume in first episode psychosis and chronic schizophrenia.Schizophr Res. 2001; 52: 37-46
Published online: June 30, 2007
Accepted: January 8, 2007
Received in revised form: December 23, 2006
Received: October 26, 2006
© 2008 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.