Regional Gray Matter Volume Abnormalities in the At Risk Mental State

doi:10.1016/j.biopsych.2006.08.009

Biological Psychiatry

Volume 61, Issue 10, 15 May 2007, Pages 1148-1156

https://doi.org/10.1016/j.biopsych.2006.08.009 Get rights and content

Background

Individuals with an At Risk Mental State (ARMS) have a very high risk of developing a psychotic disorder but the basis of this risk is unclear. We addressed this issue by studying gray matter volume in this group with magnetic resonance imaging (MRI).

Methods

Thirty-five individuals with an ARMS, 25 patients with first episode schizophrenia, and 22 healthy volunteers were studied using a 1.5T MRI scanner. Twelve (34%) of the ARMS group developed schizophrenia in the 2 years subsequent to scanning.

Results

There were significant volumetric differences between the three groups in the left insula, superior temporal gyrus, cingulate gyrus and precuneus. In these regions, the volume in the ARMS group was smaller than in volunteers but not significantly different from that in the first episode (FE) group. Direct comparison of the ARMS and control groups revealed additional areas of reduced volume in the left medial temporal cortex. Within the ARMS group, those subjects who later developed psychosis had less gray matter than subjects who did not in the right insula, inferior frontal and superior temporal gyrus.

Conclusions

The ARMS was associated with reductions in gray matter volume in areas that are also reduced in schizophrenia, suggesting that these are a correlate of an increased vulnerability to psychosis. Volumetric differences within the ARMS group may be related to the subsequent onset of schizophrenia in a subset of those at high risk.

Section snippets

Participants

The MRI data were collected as part of a research program (Prediction and early detection of schizophrenia - a prospective multilevel approach), supported by the Swiss National Science Foundation (No. 3200-057216-99; 3200-057216/3) that has been described in detail elsewhere (Riecher-Rössler et al, in press).

Subjects with an ARMS and patients experiencing their FE of psychosis were recruited through a specialized clinic for the early detection of psychosis at the Psychiatric Outpatient

Clinical Follow-up of High Risk Subjects

The mean duration of follow-up of all ARMS subjects was 25 months (median 23 months). Twelve of the 35 ARMS subjects (34%) developed a psychosis subsequent to being scanned (ARMS-T). The mean duration of follow up in this subgroup was 306 days (range, 25–1137 days). Ten of the transitions to psychosis occurred during the first year of follow-up, with one in the second year and one in the fourth. All the subjects who developed a psychosis met OPCRIT criteria for schizophrenia when re-assessed 12

Discussion

Our first prediction, that individuals with an ARMS would show volumetric deficits qualitatively similar to those seen in first episode psychosis was confirmed. The ARMS group had smaller gray matter volumes in a cluster that included the left insula and adjacent parts of the superior temporal gyrus and in a midline region that included the posterior cingulate gyrus and precuneus. There was also a trend for smaller volumes in the left parahippocampal gyrus, hippocampus and amygdala, and a

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Original articleRegional Gray Matter Volume Abnormalities in the At Risk Mental State

Background

Methods

Results

Conclusions

Section snippets

Participants

Clinical Follow-up of High Risk Subjects

Discussion

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Psychiatry Res

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Schizophr Res

Lancet

Schizophr Res

Biol Psychiatry

Schizophr Res

Schizophr Res

Schizophr Res

Neuroimage

Schizophr Res

The Scale for the Assessment of Negative Symptoms (SANS): Conceptual and theoretical foundations

Br J Psychiatry Suppl

Volumes of brain structures in twins discordant for schizophrenia

Arch Gen Psychiatry

Radiological findings in individuals at high risk of psychosis

J Neurol Neurosurg Psychiatry

Global, voxel, and cluster tests, by theory and permutation, for a difference between two groups of structural MR images of the brain

IEEE Trans Med Imaging

Cortex mapping reveals regionally specific patterns of genetic and disease-specific gray-matter deficits in twins discordant for schizophrenia

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Am J Med Genet

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Original article
Regional Gray Matter Volume Abnormalities in the At Risk Mental State