Cortical Thinning May Begin After Psychosis Onset in Patients With Schizophrenia
In people with schizophrenia, cortical thickness appears to be unaltered at the onset of psychosis but to grow thinner throughout the illness course, suggests a systematic review and meta-analysis that spanned several schizophrenia stages published in JAMA Psychiatry.
“The greater cortical thinning in long-term schizophrenia compared with first episode of psychosis with accelerated age-related reduction in cortical thickness suggests progressive neuroanatomic alterations following illness onset,” wrote study lead author Youjin Zhao, MD, PhD, of West China Hospital of Sichuan University in China, and coauthors.
To investigate cortical thinning over the course of schizophrenia, researchers analyzed data on whole-brain cortical thickness in people at clinical high-risk of schizophrenia (10 studies), at first episode of psychosis (12 studies), and with long-term schizophrenia (10 studies). In all, 2109 people across different schizophrenia stages were included.
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No significant differences in cortical thickness were identified between people at clinical high-risk and first episode of psychosis, according to the study. Compared with people at first episode of psychosis, people with long-term schizophrenia, however, showed greater cortical thinning in the right insula, right inferior frontal cortex, left lateral temporal cortex, and right temporal pole.
When researchers combined all studies, they found accelerated age-related reductions in cortical thickness in the bilateral lateral middle temporal cortex and the right pars orbitalis in the inferior frontal cortex.
“Caution in interpretation is needed because heterogeneity in samples and antipsychotic treatment may confound these results,” researchers advised.
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