A report in the January issue of Archives of General Psychiatry, one of the JAMA/Archives journals states, that in adolescents with diagnosed schizophrenia and other psychoses gray matter volume seems to decrease and cerebrospinal fluid in the frontal lobe increases compared to healthy adolescents without psychosis.

According to background information in the article:

“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.”

Dr. Celso Arango of the Hospital General Universitario Gregorio Marañón in Madrid, Spain, and his team evaluated the progression of patients’ changes in the brain during the first-episode of early-onset psychosis, as well as the relationship to diagnosis and prognosis at two-year follow-up. The study was conducted at six child and adolescent psychiatric units in Spain.

Of all participants, 25 were diagnosed with schizophrenia, 16 patients had bipolar disorder and 20 participants suffered from other psychoses, whilst 70 healthy participants served as a control group. The researchers performed a brain magnetic resonance imaging (MRI) scan in all participants at study baseline and at the two-year follow-up.

The findings revealed that that those diagnosed with schizophrenia displayed a greater volume loss in gray matter and an increase in cerebrospinal fluid in the frontal lobe at the 2-year follow-up compared with participants in the control group. Furthermore, they discovered that changes for total brain gray matter and left parietal gray matter were substantially different in participants of schizophrenic group compared with those in the control group.

Progressive brain volume changes in certain areas from participants in the schizophrenic group were linked to markers of poorer prognosis, like a longer period of hospitalization during follow-up and less improvement in negative symptoms. Greater left frontal gray matter volume loss was also linked to more weeks of hospitalization, whilst the severity of negative symptoms was related to an increase of cerebrospinal fluid in the schizophrenic group.

The researchers did not detect any important changes between patients in the bipolar group compared with those in the control group. They observed that longitudinal brain changes in patients of the control group proved consistent with the expected pattern defined for healthy adolescents.

The researchers summarize their findings, writing:

“In conclusion, we found progression of gray matter volume loss after a two-year follow-up in patients who ended up with a diagnosis of schizophrenia but not bipolar disease compared with healthy controls. Some of these pathophysiologic processes seem to be markers of poorer prognosis. To develop therapeutic strategies to counteract these pathologic progressive brain changes, future studies should focus on their neurobiological underpinnings.”

Written by Petra Rattue