Background
Existing studies of brain structural changes before the onset of schizophrenia have
considered individuals with either familial risk factors or prodromal symptomatology.
We aimed to determine whether findings from these studies are also applicable to those
at enhanced risk of developing schizophrenia for another reason—intellectual impairment.
Methods
Participants with intellectual impairment (mean IQ: 78.2) received magnetic resonance
imaging of the brain at baseline (mean age: 16 years old) and again 6 years later.
The Positive and Negative Syndrome Scale was used to assess psychotic symptoms. Participants
were dichotomized using their Positive and Negative Syndrome Scale scores at follow-up
and gray matter changes were compared between the groups using tensor based morphometry
and semiautomated region of interest analysis.
Results
Forty-six individuals had scans of sufficient quality to be included in the study.
The tensor based morphometry analyses revealed that those with psychotic symptoms
at follow-up showed significantly greater gray matter reductions over 6 years in the
medial temporal lobes bilaterally. Region of interest analyses revealed that those
individuals with psychotic symptoms at follow-up showed a reduced right hippocampal
volume at age 16 and reduced bilateral hippocampal volumes at follow-up.
Conclusions
This unique study of individuals vulnerable to schizophrenia due to intellectual impairment
highlights aberrant development in the medial temporal lobe associated with the occurrence
of psychotic symptoms. These developmental changes are also evident in populations
at enhanced risk of schizophrenia for familial and symptomatic reasons, suggesting
they are central to the development of the disorder regardless of the nature of the
vulnerability state.
Key Words
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Article info
Publication history
Published online: January 21, 2013
Accepted:
December 18,
2012
Received in revised form:
December 18,
2012
Received:
July 19,
2012
Identification
Copyright
© 2013 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
