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Am J Psychiatry. 2008 Aug;165(8):1015-23. doi: 10.1176/appi.ajp.2008.07101562. Epub 2008 Apr 1.

The anatomy of first-episode and chronic schizophrenia: an anatomical likelihood estimation meta-analysis.

Author information

  • 1Avon and Wiltshire Mental Health Partnership NHS Trust, Beechlydene Ward, Fountain Way, Wilton Rd., Salisbury SP2 7EP, United Kingdom. ian.ellison-wright@awp.nhs.uk

Abstract

OBJECTIVE:

The authors sought to map gray matter changes in first-episode schizophrenia and to compare these with the changes in chronic schizophrenia. They postulated that the data would show a progression of changes from hippocampal deficits in first-episode schizophrenia to include volume reductions in the amygdala and cortical gray matter in chronic schizophrenia.

METHOD:

A systematic search was conducted for voxel-based structural MRI studies of patients with first-episode schizophrenia and chronic schizophrenia in relation to comparison groups. Meta-analyses of the coordinates of gray matter differences were carried out using anatomical likelihood estimation. Maps of gray matter changes were constructed, and subtraction meta-analysis was used to compare them.

RESULTS:

A total of 27 articles were identified for inclusion in the meta-analyses. A marked correspondence was observed in regions affected by both first-episode schizophrenia and chronic schizophrenia, including gray matter decreases in the thalamus, the left uncus/amygdala region, the insula bilaterally, and the anterior cingulate. In the comparison of first-episode schizophrenia and chronic schizophrenia, decreases in gray matter volume were detected in first-episode schizophrenia but not in chronic schizophrenia in the caudate head bilaterally; decreases were more widespread in cortical regions in chronic schizophrenia.

CONCLUSIONS:

Anatomical changes in first-episode schizophrenia broadly coincide with a basal ganglia-thalamocortical circuit. These changes include bilateral reductions in caudate head gray matter, which are absent in chronic schizophrenia. Comparing first-episode schizophrenia and chronic schizophrenia, the authors did not find evidence for the temporolimbic progression of pathology from hippocampus to amygdala, but there was evidence for progression of cortical changes.

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PMID:
18381902
[PubMed - indexed for MEDLINE]
PMCID:
PMC2873788
Free PMC Article
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