• Online Features  This Article  • Full text  • PDF  • eTables and eFigures  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (64)  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in this journal  Topic Collections  • Neurology  • Neurology, Other  • Psychiatry  • Schizophrenia  • Psychiatry, Other  • Alert me on articles by topic  Social Bookmarking   What's this?

Tsutomu Takahashi, MD, PhD; Stephen J. Wood, PhD; Alison R. Yung, MD, MPM, FRANZCP; Bridget Soulsby, BSc; Patrick D. McGorry, MD, PhD, FRCP, FRANZCP; Michio Suzuki, MD, PhD; Yasuhiro Kawasaki, MD, PhD; Lisa J. Phillips, MPsych (Clin), PhD; Dennis Velakoulis, MBBS, FRANZCP; Christos Pantelis, MD, MRCPsych, FRANZCP

Arch Gen Psychiatry. 2009;66(4):366-376.

Context  Longitudinal magnetic resonance imaging studies have shown progressive gray matter reduction in the superior temporal gyrus during the earliest phases of schizophrenia. It is unknown whether these progressive processes predate the onset of psychosis.

Objective  To examine gray matter reduction of the superior temporal gyrus over time in individuals at risk for psychosis and in patients with first-episode psychosis.

Design  Cross-sectional and longitudinal comparisons.

Setting  Personal Assessment and Crisis Evaluation Clinic and Early Psychosis Preventions and Intervention Centre.

Participants  Thirty-five ultrahigh-risk individuals (of whom 12 later developed psychosis [UHRP] and 23 did not [UHRNP]), 23 patients with first-episode psychosis (FEP), and 22 control subjects recruited from the community.

Main Outcome Measures  Volumes of superior temporal subregions (planum polare, Heschl gyrus, planum temporale, and rostral and caudal regions) were measured at baseline and follow-up (mean, 1.8 years) and were compared across groups.

Results  In cross-sectional comparisons, only the FEP group had significantly smaller planum temporale and caudal superior temporal gyrus than other groups at baseline, whereas male UHRP subjects also had a smaller planum temporale than controls at follow-up. In longitudinal comparison, UHRP and FEP patients showed significant gray matter reduction (approximately 2%-6% per year) in the planum polare, planum temporale, and caudal region compared with controls and/or UHRNP subjects. The FEP patients also exhibited progressive gray matter loss in the left Heschl gyrus (3.0% per year) and rostral region (3.8% per year), which were correlated with the severity of delusions at follow-up.

Conclusions  A progressive process in the superior temporal gyrus precedes the first expression of florid psychosis. These findings have important implications for underlying neurobiologic features of emerging psychotic disorders and emphasize the importance of early intervention during or before the first episode of psychosis.

Author Affiliations: Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health (Drs Takahashi, Wood, Velakoulis, and Pantelis and Ms Soulsby), ORYGEN Research Centre, Early Psychosis Prevention and Intervention Centre, Personal Assessment and Crisis Evaluation Clinic (Drs Yung and McGorry) and Departments of Psychiatry (Drs Yung and McGorry) and Psychology (Dr Phillips), University of Melbourne, and Howard Florey Institute (Dr Pantelis), Melbourne, Australia; Department of Neuropsychiatry, University of Toyama, Toyama, Japan (Drs Takahashi, Suzuki, and Kawasaki); and Core Research for Evolutional Science and Technology, Japan Science and Technology Corp, Tokyo (Drs Takahashi, Suzuki, and Kawasaki).

CiteULike    Connotea    Delicious    Digg    Facebook    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLE

This Month in Archives of General Psychiatry
Arch Gen Psychiatry. 2009;66(4):347.
FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Neuroanatomical Maps of Psychosis Onset: Voxel-wise Meta-Analysis of Antipsychotic-Naive VBM Studies
Fusar-Poli et al.
Schizophr Bull 2011;0:sbr134v2-sbr134.
ABSTRACT | FULL TEXT  

Cortical Thickness Reduction in Individuals at Ultra-High-Risk for Psychosis
Jung et al.
Schizophr Bull 2011;37:839-849.
ABSTRACT | FULL TEXT  

Grey matter and social functioning correlates of glutamatergic metabolite loss in schizophrenia
Aoyama et al.
Br. J. Psychiatry 2011;198:448-456.
ABSTRACT | FULL TEXT  

Age of Onset of Schizophrenia: Perspectives From Structural Neuroimaging Studies
Gogtay et al.
Schizophr Bull 2011;37:504-513.
ABSTRACT | FULL TEXT  

Aging Effects on Regional Brain Structural Changes in Schizophrenia
Nenadic et al.
Schizophr Bull 2011;0:sbq140v1-sbq140.
ABSTRACT | FULL TEXT  

Questioning the 'neuroprotective' hypothesis: does drug treatment prevent brain damage in early psychosis or schizophrenia?
Moncrieff
Br. J. Psychiatry 2011;198:85-87.
ABSTRACT | FULL TEXT  

Gray Matter in First-Episode Schizophrenia Before and After Antipsychotic Drug Treatment. Anatomical Likelihood Estimation Meta-analyses With Sample Size Weighting
Leung et al.
Schizophr Bull 2011;37:199-211.
ABSTRACT | FULL TEXT  

Magnetic Resonance Imaging Predictors of Treatment Response in First-Episode Schizophrenia
Szeszko et al.
Schizophr Bull 2010;0:sbq126v1-sbq126.
ABSTRACT | FULL TEXT  

Progressive Structural Brain Changes During Development of Psychosis
Ziermans et al.
Schizophr Bull 2010;0:sbq113v1-sbq113.
ABSTRACT | FULL TEXT  

Etiological and Clinical Features of Childhood Psychotic Symptoms: Results From a Birth Cohort
Polanczyk et al.
Arch Gen Psychiatry 2010;67:328-338.
ABSTRACT | FULL TEXT  

Superior temporal gyrus volume in antipsychotic-naive people at risk of psychosis
Takahashi et al.
Br. J. Psychiatry 2010;196:206-211.
ABSTRACT | FULL TEXT  

Dementia Praecox Revealed
JWatch Psychiatry 2009;2009:5-5.
FULL TEXT