Progressive structural brain changes in schizophrenia.

Several important progressive brain changes occur in schizophrenia. Continuous progressive brain tissue decreases and lateral ventricular volume increases in chronically ill patients, up to at least 20 years after their first symptoms. The total duration of psychosis may be negatively associated with the grey matter volume change, and positively associated with the volume change of each of the lateral ventricles and the third ventricle. There are progressive frontal changes in males with adolescent-onset psychosis. Ultra high-risk patients who subsequently develop psychosis and first-episode psychosis patients develop significant grey matter reduction in the planum polare, planum temporale and caudal region; a progressive process in the superior temporal gyrus may precede the first expression of florid psychosis. The rate of decline in the sizes of the putamen and corpus callosum is greater in patients with a poor outcome compared to those with a good-outcome. In addition to describing these phenomena, their potential causes are discussed.