TY - JOUR
T1 - Neuroanatomical abnormalities that predate the onset of psychosis
T2 - A multicenter study
AU - Mechelli, Andrea
AU - Riecher-Rössler, Anita
AU - Meisenzahl, Eva M.
AU - Tognin, Stefania
AU - Wood, Stephen J.
AU - Borgwardt, Stefan J.
AU - Koutsouleris, Nikolaos
AU - Yung, Alison R.
AU - Stone, James M.
AU - Phillips, Lisa J.
AU - McGorry, Patrick D.
AU - Valli, Isabel
AU - Velakoulis, Dennis
AU - Woolley, James
AU - Pantelis, Christos
AU - McGuire, Philip
PY - 2011/5
Y1 - 2011/5
N2 - Context: People experiencing possible prodromal symptoms of psychosis have a very high risk of developing the disorder, but it is not possible to predict, on the basis of their presenting clinical features, which individuals will subsequently become psychotic. Recent neuroimaging studies suggest that there are volumetric differences between individuals at ultra-high risk (UHR) for psychosis who later develop psychotic disorder and those who do not. However, the samples examined to date have been small, and the findings have been inconsistent. Objective: To assess brain structure in individuals at UHR for psychosis in a larger and more representative sample than in previous studies by combining magnetic resonance imaging data from 5 different scanning sites. Design: Case-control study. Setting: Multisite. Participants: A total of 182 individuals at UHR and 167 healthy controls. Participants were observed clinically for a mean of 2 years. Forty-eight individuals (26.4%) in the UHR group developed psychosis and 134 did not. Main Outcome Measures: Magnetic resonance images were acquired from each participant. Group differences in gray matter volume were examined using optimized voxel-based morphometry. Results: The UHR group as a whole had less gray matter volume than did controls in the frontal regions bilaterally. The UHR subgroup who later developed psychosis had less gray matter volume in the left parahippocampal cortex than did the UHR subgroup who did not. Conclusions: Individuals at high risk for psychosis show alterations in regional gray matter volume regardless of whether they subsequently develop the disorder. In the UHR population, reduced left parahippocampal volume was specifically associated with the later onset of psychosis. Alterations in this region may, thus, be crucial to the expression of illness. Identifying abnormalities that specifically predate the onset of psychosis informs the development of clinical investigations designed to predict which individuals at high risk will subsequently develop the disorder.
AB - Context: People experiencing possible prodromal symptoms of psychosis have a very high risk of developing the disorder, but it is not possible to predict, on the basis of their presenting clinical features, which individuals will subsequently become psychotic. Recent neuroimaging studies suggest that there are volumetric differences between individuals at ultra-high risk (UHR) for psychosis who later develop psychotic disorder and those who do not. However, the samples examined to date have been small, and the findings have been inconsistent. Objective: To assess brain structure in individuals at UHR for psychosis in a larger and more representative sample than in previous studies by combining magnetic resonance imaging data from 5 different scanning sites. Design: Case-control study. Setting: Multisite. Participants: A total of 182 individuals at UHR and 167 healthy controls. Participants were observed clinically for a mean of 2 years. Forty-eight individuals (26.4%) in the UHR group developed psychosis and 134 did not. Main Outcome Measures: Magnetic resonance images were acquired from each participant. Group differences in gray matter volume were examined using optimized voxel-based morphometry. Results: The UHR group as a whole had less gray matter volume than did controls in the frontal regions bilaterally. The UHR subgroup who later developed psychosis had less gray matter volume in the left parahippocampal cortex than did the UHR subgroup who did not. Conclusions: Individuals at high risk for psychosis show alterations in regional gray matter volume regardless of whether they subsequently develop the disorder. In the UHR population, reduced left parahippocampal volume was specifically associated with the later onset of psychosis. Alterations in this region may, thus, be crucial to the expression of illness. Identifying abnormalities that specifically predate the onset of psychosis informs the development of clinical investigations designed to predict which individuals at high risk will subsequently develop the disorder.
UR - http://www.scopus.com/inward/record.url?scp=79955615966&partnerID=8YFLogxK
U2 - 10.1001/archgenpsychiatry.2011.42
DO - 10.1001/archgenpsychiatry.2011.42
M3 - Journal articles
C2 - 21536978
AN - SCOPUS:79955615966
SN - 0003-990X
VL - 68
SP - 489
EP - 495
JO - Archives of General Psychiatry
JF - Archives of General Psychiatry
IS - 5
ER -