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Jean A. Frazier, MD; Jay N. Giedd, MD; Susan D. Hamburger, MA, MS; Kathleen E. Albus; Debra Kaysen; A. Catherine Vaituzis; Jagath C. Rajapakse, PhD; Marge C. Lenane, MSW; Kathleen McKenna, MD; Leslie K. Jacobsen, MD; Charles T. Gordon, MD; Alan Breier, MD; Judith L. Rapoport, MD

Arch Gen Psychiatry. 1996;53(7):617-624.

Abstract
Background
Early-onset schizophrenia (first psychotic symptoms by age 12 years) has been the subject of a small number of studies, and its biological continuity with lateronset disorder has not been established. In this study, quantitative anatomic brain magnetic resonance images of children and adolescents with early-onset schizophrenia were compared with those of matched controls. Brain abnormalities in childhood-onset schizophrenia were examined in relation to those reported for later-onset schizophrenics.

Methods
Anatomic brain magnetic resonance imaging scans were obtained for 21 patients (mean±SD age, 14.6±2.1 years; range, 10 to 18 years) with childhood-onset schizophrenia (13 males, eight females) and 33 age-, sex-, height-, and weight-matched normal controls. Quantitative measurements were obtained for the cerebrum, anterior frontal region, lateral ventricles, thalamus, caudate, putamen, and globus pallidus.

Results
Total cerebral volume and midsagittal thalamic area were smaller in the patients (analysis of variance, P=.002, and analysis of covariance, P=.03, respectively); the caudate, putamen, and globus pallidus were larger in the patients (analysis of covariance, P=.05, P=.007, and P<.001, respectively); and the lateral ventricles tended to be larger in the patients (analysis of covariance, P=.06). Globus pallidus enlargement correlated with neuroleptic exposure and with age of onset of psychosis. The magnitude of abnormalities compared with controls was similar to that reported in adult studies, although there was a trend toward relatively smaller cerebral volumes for the childhood-onset group compared with controls.

Conclusion
Brain anatomic abnormalities in childhoodonset schizophrenia are similar to those reported for adult populations, indicating overall continuity between these rare childhood cases and the adult schizophrenia populations.

Author Affiliations
From the Child Psychiatry Branch (Drs Frazier, Giedd, Rajapakse, Jacobsen, and Rapoport and Mss Hamburger, Albus, Kaysen, Vaituzis, and Lenane) and Experimental Therapeutics (Dr Breier), National Institute of Mental Health, Bethesda, Md; Department of Psychiatry and Behavioral Sciences, Northwestern University Medical School, Chicago, Ill (Dr McKenna); and Child Psychiatry Division, University of Maryland at Baltimore (Dr Gordon). Dr Frazier is now with the Psychiatry Department, Massachusetts General Hospital, Harvard Medical School, Boston.

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