Childhood-onset schizophrenia: Progressive brain changes during adolescence

Background: Previous NIMH childhood onset schizophrenia (COS) anatomic brai n MRI studies found progression of ventricular volume and other structural brain anomalies at 2-year follow up across meals ages 14 to 16 years. Howev er, studies in adult patients generally do not show progression of ventricu lar volume or correlation of ventricular volume with duration of illness. T o address issues of progression of brain anomalies in schizophrenia, this r eport extends previous studies to include a third longitudinal scan, uses a larger sample size, and includes measures of the amygdala and hippocampus. Methods: Volumes of the total cerebrum, lateral ventricles, hippocampus, an d amygdala were quantified on 208 brain magnetic resonance imaging scans fr om 42 adolescents with COS (23 with one or more repeat scan) and 74 age- an d gender-matched controls (36 with one or more repeat scan), A statistical technique permitting combined use of cross-sectional and longitudinal data was used to assess age-related changes, linearity, and diagnostic group dif ferences. Results: Differential nonlinear progression of brain anomalies was seen dur ing adolescence with the total cerebrum and hippocampus decreasing and late ral ventricles increasing in the COS group. The developmental curves for th ese structures reached art asymptote by early adulthood for the COS group a nd did not significantly change with age in the control group. Conclusions: These findings reconcile less striking progression of anatomic brain images usually seen for adult schizophrenia and complement other dat a consistent with time-limited diagnostic-specific decreases in brain tissu e. Adolescence appears to be a unique period of differential brain developm ent in schizophrenia. Biol Psychiatry 1999; 46:892-898 (C) 1999 Society of Biological Psychiatry.