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PLoS One. 2014 Jul 18;9(7):e101689. doi: 10.1371/journal.pone.0101689. eCollection 2014.

Longitudinal changes in total brain volume in schizophrenia: relation to symptom severity, cognition and antipsychotic medication.

Author information

1
Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Oulu, Finland.
2
Department of Psychiatry, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom.
3
Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Oulu, Finland; Institute of Health Sciences, University of Oulu, Oulu, Finland; Unit of General Practice, Oulu University Hospital, Oulu, Finland.
4
Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Oulu, Finland.
5
Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.
6
Department of Psychiatry, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom; Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom; VU University Medical Centre, Department of Radiology, Amsterdam, The Netherlands.
7
Department of Neuroimaging, Institute of Psychiatry, King's College London, London, United Kingdom.
8
Department of Psychiatry, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom; Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom.
9
Department of Psychiatry, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom; Department of Neuropsychiatry, School of Medicine, Toho University, Tokyo, Japan.
10
Department of Psychiatry, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom; Cambridge Cognition Ltd, Bottisham, Cambridge, United Kingdom.
11
Department of Psychiatry, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom; Institute of Nuclear Medicine, University College London Hospitals NHS Foundation Trust, London, United Kingdom.
12
University of Eastern Finland, Faculty of Health Sciences, Institute of Clinical Medicine and Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland.

Abstract

Studies show evidence of longitudinal brain volume decreases in schizophrenia. We studied brain volume changes and their relation to symptom severity, level of function, cognition, and antipsychotic medication in participants with schizophrenia and control participants from a general population based birth cohort sample in a relatively long follow-up period of almost a decade. All members of the Northern Finland Birth Cohort 1966 with any psychotic disorder and a random sample not having psychosis were invited for a MRI brain scan, and clinical and cognitive assessment during 1999-2001 at the age of 33-35 years. A follow-up was conducted 9 years later during 2008-2010. Brain scans at both time points were obtained from 33 participants with schizophrenia and 71 control participants. Regression models were used to examine whether brain volume changes predicted clinical and cognitive changes over time, and whether antipsychotic medication predicted brain volume changes. The mean annual whole brain volume reduction was 0.69% in schizophrenia, and 0.49% in controls (p = 0.003, adjusted for gender, educational level, alcohol use and weight gain). The brain volume reduction in schizophrenia patients was found especially in the temporal lobe and periventricular area. Symptom severity, functioning level, and decline in cognition were not associated with brain volume reduction in schizophrenia. The amount of antipsychotic medication (dose years of equivalent to 100 mg daily chlorpromazine) over the follow-up period predicted brain volume loss (p = 0.003 adjusted for symptom level, alcohol use and weight gain). In this population based sample, brain volume reduction continues in schizophrenia patients after the onset of illness, and antipsychotic medications may contribute to these reductions.

PMID:
25036617
PMCID:
PMC4103771
DOI:
10.1371/journal.pone.0101689
[Indexed for MEDLINE]
Free PMC Article

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