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Am J Psychiatry 1995; 152:1721-1723
Copyright © 1995 by American Psychiatric Association
Brain morphology in first-episode schizophrenia
P Nopoulos, I Torres, M Flaum, NC Andreasen, JC Ehrhardt and WT Yuh
Mental Health Clinical Research Center, University of Iowa Hospitals and Clinics, College of Medicine, Iowa City 52242-1057, USA.
OBJECTIVE: Neuroimaging studies have provided robust evidence that
schizophrenia is associated with structural brain abnormalities. However,
the underlying pathophysiology of these changes is still unknown. By
evaluating brain morphology early in the course of illness, confounding
effects of treatment and duration of illness are minimized. The goal of
this study was to evaluate brain structure in patients early in the course
of schizophrenia who had received no or minimal neuroleptics. METHOD:
Magnetic resonance imaging was used to evaluate 12 male and 12 female
patients experiencing their first episode of schizophrenia (mean duration
of psychotic episode = 14 weeks) and 12 male and 12 female normal
volunteers equivalent in age, height, and parents' socioeconomic status. A
totally automated method was used to analyze scans, yielding volumes of
brain tissue and CSF, divided into lobes. RESULTS: The patient group had
significantly more total CSF than the comparison subjects. This was
accounted for by higher levels of intersulcal CSF as well as ventricular
CSF. There were no differences in total volume of brain tissue between the
two groups, but patients had a significant regionally specific decrement in
frontal lobe tissue compared with the normal subjects. CONCLUSIONS: These
findings indicate that structural brain abnormalities are present very
early in schizophrenia and may not be due to factors such as treatment or
chronicity of illness. Rather, since the abnormalities are present near the
onset of the illness, a neurodevelopmental mechanism may be suggested.
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