Abstract
BackgroundInvestigation into the whole brain morphology of early onset schizophrenia (EOS) to date has been sparse. We studied the regional brain volumes in EOS patients, and the correlations between regional volume measures and symptom severity.MethodsA total of 18 EOS patients (onset under 16 years) and 18 controls matched for age, gender, parental socioeconomic status, and height were examined. Voxel-based morphometric analysis using the Brain Analysis Morphological Mapping (BAMM) software package was employed to explore alterations of the regional grey (GM) and white matter (WM) volumes in EOS patients. Symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS).ResultsEOS patients had significantly reduced GM volume in the left parahippocampal, inferior frontal, and superior temporal gyri, compared with the controls. They also had less WM volume in the left posterior limb of the internal capsule and the left inferior longitudinal fasciculus. The positive symptom score of PANSS (higher values corresponding to more severe symptoms) was negatively related to GM volume in the bilateral posterior cingulate gyrus. The negative symptom score was positively correlated with GM volume in the right thalamus. As for the association with WM volume, the positive symptom score of PANSS was positively related to cerebellar WM (vermis region), and negatively correlated with WM in the brain stem (pons) and in the bilateral cerebellum (hemisphere region).ConclusionOur findings of regional volume alterations of GM and WM in EOS patients coincide with those of previous studies of adult onset schizophrenia patients. However, in brain regions that had no overall structural differences between EOS patients and controls (that is, the bilateral posterior cingulate gyrus, the right thalamus, the cerebellum, and the pons), within-subject analysis of EOS patients alone revealed that there were significant associations of the volume in these areas and the symptom severity. These findings suggest that at an early stage of the illness, especially for those with onset before brain maturation, a wide range of disturbed neural circuits, including these brain regions that show no apparent morphological changes, may contribute to the formation of the symptomatology.
Highlights
Investigation into the whole brain morphology of early onset schizophrenia (EOS) to date has been sparse
EOS patients had a significantly (4.0%; p < 0.009) smaller grey matter (GM) to whole brain ratio and significantly (15.4%; p < 0.001) larger cerebrospinal fluid (CSF) to whole brain ratio compared with the controls
The negative symptom score was positively correlated with GM volume in the right thalamus (Figure 4, Table 4)
Summary
Investigation into the whole brain morphology of early onset schizophrenia (EOS) to date has been sparse. Several studies have gathered and scrutinised brain samples from early onset schizophrenia (EOS) patients in various domains. Since brain morphological abnormalities are consistently found in the general samples of patients with schizophrenia (that is, adult onset populations), researchers have focused on the exploration of brain morphology in patients with EOS, defined as schizophrenia with onset under age 18 [4,5,6]. Using magnetic resonance imaging (MRI), some research groups have reported enlargement of the lateral ventricles [7,8], and regional volume reduction in the superior temporal gyrus [9,10], thalamus [8,11,12], and frontal lobe [12,13,14] in EOS patients, mirroring findings reported in individuals with adult onset schizophrenia (AOS) [15,16,17]. Compared with AOS studies, the number of EOS studies, especially by separate research groups, is still small, and studies using an independent sample of EOS patients are in demand
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