Features of structural brain abnormality detected in first-episode psychosis

Objective: Structural magnetic resonance imaging (MRI) studies that focus o n first-episode psychosis avoid some common confounds, such as chronicity o f illness, treatment effects, and long-term substance abuse. However, such studies may select subjects with poor short-term treatment response or outc ome. In this study, the authors focus on structural brain abnormalities in never or minimally treated patients who underwent MRI scanning early in the ir first episode of psychosis. Method: The authors examined 37 patients (13 medication naive, 24 previousl y treated) who were experiencing their first episode of psychosis; the mean duration of symptoms was short (31 weeks). These patients were comparable in age, gender, handedness, ethnicity, and parental socioeconomic status to a group of 25 healthy comparison subjects. A three-dimensional, inversion recovery prepared, fast spoiled gradient/recall in the steady stale scan of the whole brain that used 1.5-mm contiguous sections was performed to acqu ire a T-1-weighted data set. Human ratings of volumetric measurement of bra in structures were performed with stereological techniques on three-dimensi onal reconstructed MRIs. Results: The patient group had significant deficits in cortical gray matter , temporal lobe gray matter, and whole brain volume as well as significant enlargement of the lateral and third ventricles. Structural deviations were found in both treatment-naive and minimally treated subjects. No relations hips were found between any brain matter volumes and positive or negative s ymptoms. Conclusions: Structural brain abnormalities were distributed throughout the cortex with particular decrement evident in gray matter. This feature is c onsistent with altered cell structure and disturbed neuronal connectivity, which accounts for the functional abnormality of psychosis.