Article

Childhood onset schizophrenia: Cortical brain abnormalities as young adults

Child Psychiatry Branch, NIMH/NIH, Bethesda, MD 20892, USA.
Journal of Child Psychology and Psychiatry (Impact Factor: 5.67). 11/2006; 47(10):1003-12. DOI: 10.1111/j.1469-7610.2006.01658.x
Source: PubMed

ABSTRACT Childhood onset schizophrenia (COS) is a rare but severe form of the adult onset disorder. While structural brain imaging studies show robust, widespread, and progressive gray matter loss in COS during adolescence, there have been no longitudinal studies of sufficient duration to examine comparability with the more common adult onset illness.
Neuro-anatomic magnetic resonance scans were obtained prospectively from ages 7 through 26 in 70 children diagnosed with COS and age and sex matched healthy controls. Cortical thickness was measured at 40,962 points across the cerebral hemispheres using a novel, fully automated, validated method. Patterns of patient-control differences in cortical development were compared over a 19-year period.
Throughout the age range, the COS group had significantly smaller mean cortical thickness compared to controls. However, the COS brain developmental trajectory appeared to normalize in posterior (parietal) regions, and remained divergent in the anterior regions (frontal and temporal) regions, and the pattern of loss became more like that seen in adults.
Cortical thickness loss in COS appears to localize with age to prefrontal and temporal regions that are seen for both medication naïve and medicated adult onset patients.

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    • "Our results are consistent with decreased frontal cortical thickness and gyrification in childhood-and early-onset schizophrenia, adultonset first-episode psychosis and chronic schizophrenia (White et al., 2003; Narr et al., 2005; Greenstein et al., 2006; Voets et al., 2008; Rimol et al., 2010; Palaniyappan et al., 2011). To the best of our knowledge , this is the first study that assessed sulcal span in childhood and adolescent psychotic populations. "
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    ABSTRACT: Introduction: Recent evidence points to overlapping decreases in cortical thickness and gyrification in the frontal lobe of patients with adult-onset schizophrenia and bipolar disorder with psychotic symptoms, but it is not clear if these findings generalize to patients with a disease onset during adolescence and what may be the mechanisms underlying a decrease in gyrification. Method: This study analyzed cortical morphology using surface-based morphometry in 92 subjects (age range 11-18 years, 52 healthy controls and 40 adolescents with early-onset first-episode psychosis diagnosed with schizophrenia (n=20) or bipolar disorder with psychotic symptoms (n=20) based on a two year clinical follow up). Average lobar cortical thickness, surface area, gyrification index (GI) and sulcal width were compared between groups, and the relationship between the GI and sulcal width was assessed in the patient group. Results: Both patients groups showed decreased cortical thickness and increased sulcal width in the frontal cortex when compared to healthy controls. The schizophrenia subgroup also had increased sulcal width in all other lobes. In the frontal cortex of the combined patient group sulcal width was negatively correlated (r = -0.58, p < 0.001) with the GI. Conclusions: In adolescents with schizophrenia and bipolar disorder with psychotic symptoms there is cortical thinning, decreased GI and increased sulcal width of the frontal cortex present at the time of the first psychotic episode. Decreased frontal GI is associated with the widening of the frontal sulci which may reduce sulcal surface area. These results suggest that abnormal growth (or more pronounced shrinkage during adolescence) of the frontal cortex represents a shared endophenotype for psychosis.
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    • "Structural brain magnetic resonance imaging (MRI) studies of schizophrenia indicate widespread neuroanatomic abnormalities in cortical thickness, hippocampus, subcortical structures, and total brain measures (Shenton et al., 2001; Narr et al., 2005; Greenstein et al., 2006; Steen et al., 2006; Nesvag et al., 2008; Byne et al., 2009; Mattai et al., 2011; van Haren et al., 2011). Functional MRI and diffusion tensor imaging studies of schizophrenia also support brain dysfunction in schizophrenia involving multiple brain systems, emphasizing networks, and connectivity dysfunction rather than brain regions acting in isolation (Meyer- Lindenberg et al., 2005; Bassett et al., 2008; Lynall et al., 2010; Repovs et al., 2011). "
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    Frontiers in Psychiatry 06/2012; 3:53. DOI:10.3389/fpsyt.2012.00053
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    • "Cortical thickness (CT) was studied as a developmentally sensitive (Raznahan et al., 2010) sMRI index of cortical structure that can be mapped at high-spatial resolution and is well established to vary in a regionally specific manner according to genetic (Lenroot et al., 2009; Rimol et al., 2010; Shaw et al., 2009), cognitive (Shaw et al., 2006) and pathological influences (Gogtay et al., 2007; Greenstein et al., 2006). "
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