Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo (USP), São Paulo, Brazil.
Psychol Med. 2011 Aug;41(8):1677-89. doi: 10.1017/S0033291710002163. Epub 2010 Dec 10.
Some neuroimaging studies have supported the hypothesis of progressive brain changes after a first episode of psychosis. We aimed to determine whether (i) first-episode psychosis patients would exhibit more pronounced brain volumetric changes than controls over time and (ii) illness course/treatment would relate to those changes.
Longitudinal regional grey matter volume and ventricle:brain ratio differences between 39 patients with first-episode psychosis (including schizophrenia and schizophreniform disorder) and 52 non-psychotic controls enrolled in a population-based case-control study.
While there was no longitudinal difference in ventricle:brain ratios between first-episode psychosis subjects and controls, patients exhibited grey matter volume changes, indicating a reversible course in the superior temporal cortex and hippocampus compared with controls. A remitting course was related to reversal of baseline temporal grey matter deficits.
Our findings do not support the hypothesis of brain changes indicating a progressive course in the initial phase of psychosis. Rather, some brain volume abnormalities may be reversible, possibly associated with a better illness course.
一些神经影像学研究支持首发精神病后大脑进行性变化的假说。我们旨在确定（i）首发精神病患者是否会随着时间的推移表现出比对照组更明显的脑容积变化，以及（ii）疾病过程/治疗是否与这些变化有关。
在一项基于人群的病例对照研究中，我们比较了 39 名首发精神病（包括精神分裂症和分裂情感障碍）患者和 52 名非精神病对照者的纵向区域性灰质体积和脑室/脑比差异。
首发精神病患者和对照组之间的脑室/脑比在纵向没有差异，而患者表现出灰质体积变化，表明与对照组相比，颞上回和海马存在可逆的过程。缓解病程与颞部灰质基线缺陷的逆转有关。
我们的研究结果不支持首发精神病初始阶段大脑变化表明进行性病程的假说。相反，一些脑体积异常可能是可逆的，可能与更好的疾病过程有关。
