© 2006 The Royal College of Psychiatrists
REVIEW ARTICLE |
Brain volume in first-episode schizophrenia
Systematic review and meta-analysis of magnetic resonance imaging studies
Department of Psychiatry, University of North Carolina at Chapel Hill, North Carolina, USA
Correspondence: Dr R. Grant Steen, Department of Psychiatry, University of North Carolina at Chapel Hill, Campus Box 7160, Chapel Hill, North Carolina 27599-7160, USA. Tel: +1 919 966 8382; e-mail: Grant_Steen{at}med.unc.edu
Background Studies of people with schizophrenia assessed using magnetic resonance imaging (MRI) usually include patients with first-episode and chronic disease, yet brain abnormalities may be limited to those with chronic schizophrenia.
Aims To determine whether patients with a first episode of schizophrenia have characteristic brain abnormalities.
Method Systematic review and meta-analysis of 66 papers comparing brain volume in patients with a first psychotic episode with volume in healthy controls.
Results A total of 52 cross-sectional studies included 1424 patients with a first psychotic episode; 16 longitudinal studies included 465 such patients. Meta-analysis suggests that whole brain and hippocampal volume are reduced (both P<0.0001) and that ventricular volume is increased (P<0.0001) in these patients relative to healthy controls.
Conclusions Average volumetric changes are close to the limit of detection by MRI methods. It remains to be determined whether schizophrenia is a neurodegenerative process that begins at about the time of symptom onset, or whether it is better characterised as a neurodevelopmental process that produces abnormal brain volumes at an early age.
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BJP 2006 188: 501-a21.[Full Text]
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