Temporal lobe volume changes in people at high risk of schizophrenia with psychotic symptoms

Abstract

BackgroundMagnetic resonance imaging (MRI) has demonstrated abnormalities of brain structure, particularly of the temporal lobes, in schizophrenia. These are thought to be neurodevelopmental in origin, but when they become evident is unknown.AimsTo determine iftemporal lobe volumes reduce during the development of symptoms of schizophrenia in initially well people at high riskofthis disorder.MethodA group of 66 people who had at least two first— or second-degree relatives with schizophrenia and a control group of 20 healthy people had a structural MRI scan ofthe whole brain which was repeated after approximately 2 years. Regions of interest, specifically the amygdala-hippocampus complex and the temporal lobes, were traced semi-automatically by three masked raters with good inter— and intrarater reliabilityResultsRegional brain volume changes over 2 years did notdiffer between high-risk and healthy participants. Within the high-risk group, the 19 people with psychotic symptoms (12 at first assessment) had a mean reduction of 2163 mm3 intherighttemporal lobe compared with 97 mm3 in the 47 without symptoms (P⩵0.02).ConclusionsOur findings suggest that people at high risk of schizophrenia with psychotic symptoms show reductions in temporal lobe volumes.

Much ado about much: Stress, dynamic biomarkers and HPA axis dysregulation along the trajectory to psychosis

“…Moreover, symptoms, perceived stress and neurobiological markers may fluctuate over time, dissociate from, or converge with each other at various points, and trajectories of specific markers may ultimately differ across high-risk groups. For example, although diurnal cortisol elevations may develop proximally to the onset of illness, there is evidence that other static markers (such as HV) emerge much earlier in the course of illness (Francis et al, 2013;Lawrie et al, 2002). Ultimately, longitudinal studies of subjects at familial and clinical high-risk for psychosis will be required to illuminate the dynamic course of stress-vulnerability along the psychosis continuum.…”

A systematic review of the effects of antipsychotic drugs on brain volume

“…Longitudinal follow-up of the Australian cohort suggested reduction of the superior temporal gyrus and insular cortex, but most of the sample were treated with antipsychotics (Takahashi et al 2009 b, c). In the Scottish study, individuals in the high-risk group with psychotic symptoms showed greater right temporal lobe reduction than those who were unsymptomatic, but they did not differ from controls (Lawrie et al 2002).…”

Bilateral hippocampal volume increases after long-term lithium treatment in patients with bipolar disorder: a longitudinal MRI study

“…To date, longitudinal studies of HC volume have been performed in patients with adult and childhood onset schizophrenia (DeLisi et al 1997;Giedd et al 1999;Jacobsen et al 1998;Kasai et al 2003;Lawrie et al 2002;Whitworth et al 2005), with PTSD (Bonne et al 2001;Bremner et al 2005;Vermetten et al 2003), and with MDD (Frodl et al 2004;O'Brien et al 2004;Vythilingam et al 2004). To our knowledge, no such studies have been reported in patients with BD, despite the recognized need to examine medication effects.…”