Gregor E Berger1,2,3,4, Cali F Bartholomeusz1,2,5,4, Stephen J Wood1,2,5,6, Anthony Ang5, Lisa J Phillips7, Tina Proffitt1,2, Warrick J Brewer1,2, Deidre J Smith8, Barnaby Nelson1,2, Ashleigh Lin9, Stefan Borgwardt10, Dennis Velakoulis5, Alison R Yung11,12, Patrick D McGorry1,2, Christos Pantelis5. 1. 1 Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia. 2. 2 Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia. 3. 3 Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland. 4. Joint first authors, these authors contributed equally to the writing of this manuscript. 5. 4 Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Parkville, VIC, Australia. 6. 5 School of Psychology, University of Birmingham, Birmingham, UK. 7. 6 Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC, Australia. 8. 7 The Melbourne Clinic, Department of Psychiatry, The University of Melbourne, Richmond, VIC, Australia. 9. 8 Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia. 10. 9 Department of Psychiatry, University of Basel, Basel, Switzerland. 11. 10 Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK. 12. 11 Greater Manchester West NHS Mental Health Foundation Trust, Manchester, UK.
Abstract
OBJECTIVE: Ventricular enlargement is common in established schizophrenia; however, data from ultra high-risk for psychosis and first-episode psychosis studies are inconclusive. This study aims to investigate ventricular volumes at different stages of psychosis. METHODS: Ventricular volumes were measured using a semi-automated and highly reliable method, for 89 established schizophrenia, 162 first-episode psychosis, 135 ultra high-risk for psychosis and 87 healthy controls using 1.5T magnetic resonance images. Clinical outcome diagnoses for ultra high-risk for psychosis were evaluated at long-term follow-up (mean: 7.5 years). RESULTS: Compared to controls, we identified significant ventricular enlargement of 36.2% in established schizophrenia ( p < 0.001). Ventricular enlargement was not significant in first-episode psychosis (6%) or ultra high-risk for psychosis (-3%). Examination across stages of schizophrenia-spectrum diagnoses subgroups revealed a significant linear trend ( p = 0.006; established schizophrenia = 36.2%, first-episode psychosis schizophrenia = 18.5%, first-episode psychosis schizophreniform = -4.2% and ultra high-risk for psychosis-schizophrenia converters = -18.5%). CONCLUSION: Ventricular enlargement is apparent in patients with established schizophrenia but is not a feature at the earliest stages of illness (ultra high-risk for psychosis and first-episode psychosis). Further research is needed to fully characterize the nature and timing of ventricular volume changes early in the course of illness and how these changes impact outcomes.
OBJECTIVE:Ventricular enlargement is common in established schizophrenia; however, data from ultra high-risk for psychosis and first-episode psychosis studies are inconclusive. This study aims to investigate ventricular volumes at different stages of psychosis. METHODS: Ventricular volumes were measured using a semi-automated and highly reliable method, for 89 established schizophrenia, 162 first-episode psychosis, 135 ultra high-risk for psychosis and 87 healthy controls using 1.5T magnetic resonance images. Clinical outcome diagnoses for ultra high-risk for psychosis were evaluated at long-term follow-up (mean: 7.5 years). RESULTS: Compared to controls, we identified significant ventricular enlargement of 36.2% in established schizophrenia ( p < 0.001). Ventricular enlargement was not significant in first-episode psychosis (6%) or ultra high-risk for psychosis (-3%). Examination across stages of schizophrenia-spectrum diagnoses subgroups revealed a significant linear trend ( p = 0.006; established schizophrenia = 36.2%, first-episode psychosis schizophrenia = 18.5%, first-episode psychosis schizophreniform = -4.2% and ultra high-risk for psychosis-schizophrenia converters = -18.5%). CONCLUSION:Ventricular enlargement is apparent in patients with established schizophrenia but is not a feature at the earliest stages of illness (ultra high-risk for psychosis and first-episode psychosis). Further research is needed to fully characterize the nature and timing of ventricular volume changes early in the course of illness and how these changes impact outcomes.
Authors: Diego Romero-Miguel; Marta Casquero-Veiga; Karina S MacDowell; Sonia Torres-Sanchez; José Antonio Garcia-Partida; Nicolás Lamanna-Rama; Ana Romero-Miranda; Esther Berrocoso; Juan C Leza; Manuel Desco; María Luisa Soto-Montenegro Journal: Int J Neuropsychopharmacol Date: 2021-09-21 Impact factor: 5.176