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Progressive gray matter reduction of the superior temporal gyrus during transition to psychosis.
Arch Gen Psychiatry 2009; 66(4):366-76AG

Abstract

CONTEXT

Longitudinal magnetic resonance imaging studies have shown progressive gray matter reduction in the superior temporal gyrus during the earliest phases of schizophrenia. It is unknown whether these progressive processes predate the onset of psychosis.

OBJECTIVE

To examine gray matter reduction of the superior temporal gyrus over time in individuals at risk for psychosis and in patients with first-episode psychosis.

DESIGN

Cross-sectional and longitudinal comparisons.

SETTING

Personal Assessment and Crisis Evaluation Clinic and Early Psychosis Preventions and Intervention Centre.

PARTICIPANTS

Thirty-five ultrahigh-risk individuals (of whom 12 later developed psychosis [UHRP] and 23 did not [UHRNP]), 23 patients with first-episode psychosis (FEP), and 22 control subjects recruited from the community.

MAIN OUTCOME MEASURES

Volumes of superior temporal subregions (planum polare, Heschl gyrus, planum temporale, and rostral and caudal regions) were measured at baseline and follow-up (mean, 1.8 years) and were compared across groups.

RESULTS

In cross-sectional comparisons, only the FEP group had significantly smaller planum temporale and caudal superior temporal gyrus than other groups at baseline, whereas male UHRP subjects also had a smaller planum temporale than controls at follow-up. In longitudinal comparison, UHRP and FEP patients showed significant gray matter reduction (approximately 2%-6% per year) in the planum polare, planum temporale, and caudal region compared with controls and/or UHRNP subjects. The FEP patients also exhibited progressive gray matter loss in the left Heschl gyrus (3.0% per year) and rostral region (3.8% per year), which were correlated with the severity of delusions at follow-up.

CONCLUSIONS

A progressive process in the superior temporal gyrus precedes the first expression of florid psychosis. These findings have important implications for underlying neurobiologic features of emerging psychotic disorders and emphasize the importance of early intervention during or before the first episode of psychosis.

Authors+Show Affiliations

Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Australia. tsutomu@med.u-toyama.ac.jpNo 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)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19349306

Citation

Takahashi, Tsutomu, et al. "Progressive Gray Matter Reduction of the Superior Temporal Gyrus During Transition to Psychosis." Archives of General Psychiatry, vol. 66, no. 4, 2009, pp. 366-76.
Takahashi T, Wood SJ, Yung AR, et al. Progressive gray matter reduction of the superior temporal gyrus during transition to psychosis. Arch Gen Psychiatry. 2009;66(4):366-76.
Takahashi, T., Wood, S. J., Yung, A. R., Soulsby, B., McGorry, P. D., Suzuki, M., ... Pantelis, C. (2009). Progressive gray matter reduction of the superior temporal gyrus during transition to psychosis. Archives of General Psychiatry, 66(4), pp. 366-76. doi:10.1001/archgenpsychiatry.2009.12.
Takahashi T, et al. Progressive Gray Matter Reduction of the Superior Temporal Gyrus During Transition to Psychosis. Arch Gen Psychiatry. 2009;66(4):366-76. PubMed PMID: 19349306.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Progressive gray matter reduction of the superior temporal gyrus during transition to psychosis. AU - Takahashi,Tsutomu, AU - Wood,Stephen J, AU - Yung,Alison R, AU - Soulsby,Bridget, AU - McGorry,Patrick D, AU - Suzuki,Michio, AU - Kawasaki,Yasuhiro, AU - Phillips,Lisa J, AU - Velakoulis,Dennis, AU - Pantelis,Christos, PY - 2009/4/8/entrez PY - 2009/4/8/pubmed PY - 2009/4/23/medline SP - 366 EP - 76 JF - Archives of general psychiatry JO - Arch. Gen. Psychiatry VL - 66 IS - 4 N2 - CONTEXT: Longitudinal magnetic resonance imaging studies have shown progressive gray matter reduction in the superior temporal gyrus during the earliest phases of schizophrenia. It is unknown whether these progressive processes predate the onset of psychosis. OBJECTIVE: To examine gray matter reduction of the superior temporal gyrus over time in individuals at risk for psychosis and in patients with first-episode psychosis. DESIGN: Cross-sectional and longitudinal comparisons. SETTING: Personal Assessment and Crisis Evaluation Clinic and Early Psychosis Preventions and Intervention Centre. PARTICIPANTS: Thirty-five ultrahigh-risk individuals (of whom 12 later developed psychosis [UHRP] and 23 did not [UHRNP]), 23 patients with first-episode psychosis (FEP), and 22 control subjects recruited from the community. MAIN OUTCOME MEASURES: Volumes of superior temporal subregions (planum polare, Heschl gyrus, planum temporale, and rostral and caudal regions) were measured at baseline and follow-up (mean, 1.8 years) and were compared across groups. RESULTS: In cross-sectional comparisons, only the FEP group had significantly smaller planum temporale and caudal superior temporal gyrus than other groups at baseline, whereas male UHRP subjects also had a smaller planum temporale than controls at follow-up. In longitudinal comparison, UHRP and FEP patients showed significant gray matter reduction (approximately 2%-6% per year) in the planum polare, planum temporale, and caudal region compared with controls and/or UHRNP subjects. The FEP patients also exhibited progressive gray matter loss in the left Heschl gyrus (3.0% per year) and rostral region (3.8% per year), which were correlated with the severity of delusions at follow-up. CONCLUSIONS: A progressive process in the superior temporal gyrus precedes the first expression of florid psychosis. These findings have important implications for underlying neurobiologic features of emerging psychotic disorders and emphasize the importance of early intervention during or before the first episode of psychosis. SN - 1538-3636 UR - https://www.unboundmedicine.com/medline/citation/19349306/Progressive_gray_matter_reduction_of_the_superior_temporal_gyrus_during_transition_to_psychosis_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=19349306.ui DB - PRIME DP - Unbound Medicine ER -