A new study has revealed schizophrenia may lead to progressive brain changes among adolescents, such as loss of gray matter in the brain.
It found that adolescents diagnosed with schizophrenia and other psychoses appear to show greater decreases in gray matter volume and increases in cerebrospinal fluid in the frontal lobe compared to healthy adolescents without a diagnosis of psychosis.
"Progressive loss of brain gray matter (GM) has been reported in childhood-onset schizophrenia; however, it is uncertain whether these changes are shared by pediatric patients with different psychoses," the researchers said.
Celso Arango, M.D., Ph.D., of the Hospital General Universitario Gregorio Maranon, Madrid, Spain, and colleagues, examined the progression of brain changes in first-episode early-onset psychosis and the relationship to diagnosis and prognosis at two-year follow-up among patients at six child and adolescent psychiatric units in Spain.
The researchers 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 study baseline and after two years of follow-up.
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 hospitalisation during follow-up and less improvement in negative symptoms.
Greater left frontal gray matter volume loss was related to more weeks of hospitalisation whereas severity of negative symptoms correlated with cerebrospinal fluid increase in patients with schizophrenia.
However, the researchers 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.
The findings have been published in the January issue of Archives of General Psychiatry, one of the JAMA/Archives journals.