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Gray matter changes and cognitive predictors of 2-year follow-up abnormalities in early-onset first-episode psychosis

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Abstract

This study aims to examine regional gray matter (GM) changes over a period of 2 years in patients diagnosed with early-onset first-episode psychosis (EO-FEP), and to identify baseline predictors of abnormalities at the follow-up. Fifty-nine patients with EO-FEP aged 11–17 years were assessed. Magnetic resonance imaging was carried out at admission and 2 years later. Changes over time were assessed with voxel-based morphometry. Fifty-nine patients (34 schizophrenia—SCZ, 15 bipolar disorder—BP, and 10 other psychotic disorders) and 70 healthy controls were assessed. At baseline no differences were found between the EO-FEP groups and control subjects. Over time, SCZ patients presented a larger GM decrease in the orbitofrontal cortex, anterior midline frontal cortex, cingulate, left caudate, and thalamus. BP patients also had a larger GM decrease in the right putamen, right orbitofrontal cortex, and anterior and midline region of the right superior frontal gyrus and left caudate, but with fewer areas showing significant differences than in the comparison between SCZ and controls. In the cross-sectional analysis, only SCZ patients showed differences with respect to controls in some GM areas. Significant baseline predictors of a 2-year reduction in GM were IQ and working memory. EO-FEP patients did not show differences in GM compared to controls at baseline. Both SCZ and BP patients showed a greater decrease in specific areas during the first 2 years. At follow-up, only SCZ patients differed significantly from controls in specific brain areas. The GM reduction was predicted by baseline cognitive variables.

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Acknowledgements

This study was supported by a grant from the Carlos III Institute of Health, Cooperative Research Thematic Network (RETICS)-G03/032 and from the Spanish Ministry of Science and Innovation, CIBERSAM. Support was also given by SGR 489, and by the Alicia Koplowitz Foundation and S2010/BMD-2422 AGES.

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Authors and Affiliations

  1. Department of Child and Adolescent Psychiatry and Psychology, SGR-489, Neurosciences Institute, Hospital Clínic of Barcelona, IDIBAPS, CIBERSAM, Villarroel, 170, 08036, Barcelona, Spain

    Josefina Castro-Fornieles, Immaculada Baeza & Elena de la Serna

  2. Department of Psychiatry and Psychobiology, University of Barcelona, Barcelona, Spain

    Josefina Castro-Fornieles

  3. Image Diagnostic Center, Hospital Clinic de Barcelona, IDIBAPS, Barcelona, Spain

    Nuria Bargalló & Anna Calvo

  4. Department of Child and Adolescent Psychiatry, Instituto de Investigación Sanitaria Gregorio Marañón, IiSGM, Hospital General Universitario Gregorio Marañón, School of Medicine, CIBERSAM, Universidad Complutense, Madrid, Spain

    Celso Arango, Mara Parellada, Carmen Moreno, Joost Janssen & Marta Rapado-Castro

  5. Department of Psychiatry, Hospital Santiago Apóstol, CIBERSAM, EHU/University of the Basque Country, Vitoria, Spain

    Ana Gonzalez-Pinto

  6. Department of Child and Adolescent Psychiatry and Psychology, CIBERSAM, Hospital Infantil Universitario Niño Jesús, Madrid, Spain

    Montserrat Graell

  7. Child and Adolescent Mental Health Unit, Department of Psychiatry and Psychology, CIBERSAM, Hospital Universitario Marqués de Valdecilla, Santander, Spain

    Soraya Otero

  8. Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands

    Joost Janssen

Authors
  1. Josefina Castro-Fornieles
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  2. Nuria Bargalló
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  3. Anna Calvo
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  4. Celso Arango
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  5. Immaculada Baeza
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  6. Ana Gonzalez-Pinto
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  7. Mara Parellada
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  8. Montserrat Graell
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  9. Carmen Moreno
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  10. Soraya Otero
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  11. Joost Janssen
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  12. Marta Rapado-Castro
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  13. Elena de la Serna
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Corresponding author

Correspondence to Josefina Castro-Fornieles.

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Conflict of interest

Dr. Rapado Castro was supported by a Sara Borrell Health Research Fellowship from the Institute of Health Carlos III, Spanish Ministry of Economy and Competitiveness, an Alicia Koplowitz Research Grant, an Alicia Koplowitz Short-Term Visiting Fellowship from the Alicia Koplowitz Foundation and an IiSGM Fellowship Award for Short-Term Placements from the Health Research Institute from the Hospital Gregorio Marañon (IiSGM) (Madrid, Spain). Dr. Gonzalez-Pinto has received grants and served as consultant, advisor or CME speaker for the following entities: Almirall, AstraZeneca, Bristol-Myers Squibb, Cephalon, Eli Lilly, Glaxo-Smith-Kline, Janssen-Cilag, Jazz, Johnson & Johnson, Lundbeck, Merck, Otsuka, Pfizer, Sanofi-Aventis, Servier, Shering-Plough, Solvay, the Spanish Ministry of Science and Innovation (CIBERSAM), the Ministry of Science (Carlos III Institute), the Basque Government, the Stanley Medical Research Institute, and Wyeth. Dr. Graell was received honoraria or grants from Eli Lilly and Shire. Dr. Arango has been a consultant to or has received honoraria or grants from Abbot, AMGEN, AstraZeneca, Bristol-Myers Squibb, Caja Navarra, CIBERSAM, Fundación Alicia Koplowitz, Instituto de Salud Carlos III, Janssen-Cilag, Lundbeck, Merck, Ministerio de Ciencia e Innovación, Ministerio de Sanidad, Ministerio de Economía y Competitividad, Mutua Madrileña, Otsuka, Pfizer, Roche, Servier, Shire, Schering Plough and Takeda.

Ethical Standards

The study was approved by the institutional review board at each clinical center. All parents or legal guardians gave written informed consent before the study began and all patients agreed to participate.

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Castro-Fornieles, J., Bargalló, N., Calvo, A. et al. Gray matter changes and cognitive predictors of 2-year follow-up abnormalities in early-onset first-episode psychosis. Eur Child Adolesc Psychiatry 27, 113–126 (2018). https://doi.org/10.1007/s00787-017-1013-z

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  • DOI: https://doi.org/10.1007/s00787-017-1013-z

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