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Three-year longitudinal population-based volumetric MRI study in first-episode schizophrenia spectrum patients

Published online by Cambridge University Press:  26 September 2013

R. Roiz-Santiáñez ,
R. Ayesa-Arriola ,
D. Tordesillas-Gutiérrez ,
V. Ortiz-García de la Foz ,
R. Pérez-Iglesias ,
A. Pazos ,
E. Sánchez  and
B. Crespo-Facorro
R. Roiz-Santiáñez*
Affiliation:
Marqués de Valdecilla University Hospital, IFIMAV, Santander, Spain Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain
R. Ayesa-Arriola
Affiliation:
Marqués de Valdecilla University Hospital, IFIMAV, Santander, Spain Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain
D. Tordesillas-Gutiérrez
Affiliation:
Marqués de Valdecilla University Hospital, IFIMAV, Santander, Spain Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain
V. Ortiz-García de la Foz
Affiliation:
Marqués de Valdecilla University Hospital, IFIMAV, Santander, Spain Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain
R. Pérez-Iglesias
Affiliation:
Marqués de Valdecilla University Hospital, IFIMAV, Santander, Spain Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain Department of Psychosis Studies, Institute of Psychiatry, King's College London, UK
A. Pazos
Affiliation:
Marqués de Valdecilla University Hospital, IFIMAV, Santander, Spain CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain Department of Pharmacology, School of Medicine, University of Cantabria, and Instituto de Biomedicina y Biotecnología de Cantabria (CSIC-UC-IDICAN), Santander, Spain
E. Sánchez
Affiliation:
Department of Neuroradiology, Marqués de Valdecilla University Hospital, Santander, Spain
B. Crespo-Facorro
Affiliation:
Marqués de Valdecilla University Hospital, IFIMAV, Santander, Spain Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain
*
*Address for correspondence: Professor R. Roiz-Santiáñez, Unidad Investigación Psiquiatría, Hospital Universitario Marqués de Valdecilla, Avenida de Valdecilla s/n, 39008 Santander, Spain. (Email: [email protected])
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Abstract

Background

Schizophrenia is a chronic brain disorder associated with structural brain abnormalities already present at the onset of the illness. Whether these brain abnormalities might progress over time is still under debate.

Method

The aim of this study was to investigate likely progressive brain volume changes in schizophrenia during the first 3 years after initiating antipsychotic treatment. The study included 109 patients with a schizophrenia spectrum disorder and a control group of 76 healthy subjects. Subjects received detailed clinical and cognitive assessment and structural magnetic resonance imaging (MRI) at regular time points during a 3-year follow-up period. The effects of brain changes on cognitive and clinical variables were examined along with the impact of potential confounding factors.

Results

Overall, patients and healthy controls exhibited a similar pattern of brain volume changes. However, patients showed a significant lower progressive decrease in the volume of the caudate nucleus than control subjects (F1,307.2 = 2.12, p = 0.035), with healthy subjects showing a greater reduction than patients during the follow-up period. Clinical and cognitive outcomes were not associated with progressive brain volume changes during the early years of the illness.

Conclusions

Brain volume abnormalities that have been consistently observed at the onset of non-affective psychosis may not inevitably progress, at least over the first years of the illness. Taking together with clinical and cognitive longitudinal data, our findings, showing a lack of brain deterioration in a substantial number of individuals, suggest a less pessimistic and more reassuring perception of the illness.

Keywords

Antipsychoticsbrain morphologyclinical cognitioncognitivefirst episodefollow-up studiespsychosisschizophreniastructural magnetic resonance imaging
Type
Original Articles
Information
Psychological Medicine , Volume 44 , Issue 8 , June 2014 , pp. 1591 - 1604
Copyright
Copyright © Cambridge University Press 2013 

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