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Comparison of progressive cortical gray matter loss in childhood-onset schizophrenia with that in childhood-onset atypical psychoses.
Arch Gen Psychiatry 2004; 61(1):17-22AG

Abstract

BACKGROUND

Recent anatomical brain magnetic resonance imaging (MRI) studies show a striking postpsychotic progressive loss of cortical gray matter (GM) in patients with childhood-onset schizophrenia (COS), which appears greater than that seen for adult patients. However, the diagnostic specificity and the relationship of these changes to drug treatment and cognitive functioning remain unclear. We performed a comparative prospective brain MRI study in patients with COS and pediatric patients with transient psychosis with behavior problems (psychosis not otherwise specified) provisionally considered multidimensionally impaired (MDI). We hypothesized that cortical GM loss would occur in patients with COS but not in adolescents with atypical psychoses.

METHODS

Anatomical brain MRI was performed at baseline and follow-up in 19 patients in the MDI group (mean [SD] age of 13.3 [3.1] years); in 23 patients with COS matched for age, sex, IQ score, and drug treatment (mean [SD] age of 13.9 [2.5] years); and 38 healthy control subjects matched for age and sex (mean [SD] age of 13.3 [3.1] years). The mean (SD) follow-up was 2.5 (0.8) years. Volumes of the cerebrum and total and regional GM were obtained by using automated analysis, and percent change in volume across time was calculated. One-way analyses of variance with post hoc Tukey Honestly Significantly Different comparisons were performed to examine group differences in the percent change in GM across follow-up.

RESULTS

The COS group had significantly greater total, frontal, temporal, and parietal GM loss than did the MDI or healthy control groups; analysis of variance post hoc P values ranged from.03 to.001. The MDI and control groups did not differ significantly from each other.

CONCLUSIONS

The cortical GM volume loss in COS appears diagnostically specific; it was not seen in children and adolescents with atypical psychosis. Because both patient groups had similar early developmental patterns, cognitive functioning, medications, and hospitalizations, this progressive loss appears to be intrinsic to COS. An ongoing neurodevelopmental process and/or brain response specific to the illness could account for these changes.

Authors+Show Affiliations

Child Psychiatry Branch, National Institute of Mental Health/NIH, Building 10, Room 3N202, 10 Center Drive, MSC 1600, Bethesda, MD 20892-1600, USA. nitin@codon.nih.govNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

14706940

Citation

Gogtay, Nitin, et al. "Comparison of Progressive Cortical Gray Matter Loss in Childhood-onset Schizophrenia With That in Childhood-onset Atypical Psychoses." Archives of General Psychiatry, vol. 61, no. 1, 2004, pp. 17-22.
Gogtay N, Sporn A, Clasen LS, et al. Comparison of progressive cortical gray matter loss in childhood-onset schizophrenia with that in childhood-onset atypical psychoses. Arch Gen Psychiatry. 2004;61(1):17-22.
Gogtay, N., Sporn, A., Clasen, L. S., Nugent, T. F., Greenstein, D., Nicolson, R., ... Rapoport, J. L. (2004). Comparison of progressive cortical gray matter loss in childhood-onset schizophrenia with that in childhood-onset atypical psychoses. Archives of General Psychiatry, 61(1), pp. 17-22.
Gogtay N, et al. Comparison of Progressive Cortical Gray Matter Loss in Childhood-onset Schizophrenia With That in Childhood-onset Atypical Psychoses. Arch Gen Psychiatry. 2004;61(1):17-22. PubMed PMID: 14706940.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of progressive cortical gray matter loss in childhood-onset schizophrenia with that in childhood-onset atypical psychoses. AU - Gogtay,Nitin, AU - Sporn,Alexandra, AU - Clasen,Liv S, AU - Nugent,Tom F,3rd AU - Greenstein,Deanna, AU - Nicolson,Rob, AU - Giedd,Jay N, AU - Lenane,Marge, AU - Gochman,Pete, AU - Evans,Alan, AU - Rapoport,Judith L, PY - 2004/1/7/pubmed PY - 2004/2/18/medline PY - 2004/1/7/entrez SP - 17 EP - 22 JF - Archives of general psychiatry JO - Arch. Gen. Psychiatry VL - 61 IS - 1 N2 - BACKGROUND: Recent anatomical brain magnetic resonance imaging (MRI) studies show a striking postpsychotic progressive loss of cortical gray matter (GM) in patients with childhood-onset schizophrenia (COS), which appears greater than that seen for adult patients. However, the diagnostic specificity and the relationship of these changes to drug treatment and cognitive functioning remain unclear. We performed a comparative prospective brain MRI study in patients with COS and pediatric patients with transient psychosis with behavior problems (psychosis not otherwise specified) provisionally considered multidimensionally impaired (MDI). We hypothesized that cortical GM loss would occur in patients with COS but not in adolescents with atypical psychoses. METHODS: Anatomical brain MRI was performed at baseline and follow-up in 19 patients in the MDI group (mean [SD] age of 13.3 [3.1] years); in 23 patients with COS matched for age, sex, IQ score, and drug treatment (mean [SD] age of 13.9 [2.5] years); and 38 healthy control subjects matched for age and sex (mean [SD] age of 13.3 [3.1] years). The mean (SD) follow-up was 2.5 (0.8) years. Volumes of the cerebrum and total and regional GM were obtained by using automated analysis, and percent change in volume across time was calculated. One-way analyses of variance with post hoc Tukey Honestly Significantly Different comparisons were performed to examine group differences in the percent change in GM across follow-up. RESULTS: The COS group had significantly greater total, frontal, temporal, and parietal GM loss than did the MDI or healthy control groups; analysis of variance post hoc P values ranged from.03 to.001. The MDI and control groups did not differ significantly from each other. CONCLUSIONS: The cortical GM volume loss in COS appears diagnostically specific; it was not seen in children and adolescents with atypical psychosis. Because both patient groups had similar early developmental patterns, cognitive functioning, medications, and hospitalizations, this progressive loss appears to be intrinsic to COS. An ongoing neurodevelopmental process and/or brain response specific to the illness could account for these changes. SN - 0003-990X UR - https://www.unboundmedicine.com/medline/citation/14706940/Comparison_of_progressive_cortical_gray_matter_loss_in_childhood_onset_schizophrenia_with_that_in_childhood_onset_atypical_psychoses_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=14706940.ui DB - PRIME DP - Unbound Medicine ER -