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Arango C, Rapado-Castro M, Reig S, Castro-Fornieles J, González-Pinto A, Otero S, Baeza I, Moreno C, Graell M, Janssen J, Parellada M, Moreno D, Bargalló N, Desco M. Progressive brain changes in children and adolescents with first-episode psychosis. Arch Gen Psychiatry . 2012 Jan ; 69(1):16-26. PubMed Abstract

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Comment by:  Nitin Gogtay
Submitted 25 January 2012 Posted 25 January 2012

This is a well-done, prospective imaging study by Arango et al. looking at brain changes in early-onset psychosis. Early-onset psychosis populations in general are less studied, but are important, as they provide a window into earlier neurodevelopmental correlates and are less likely to show environmental influences. As quoted in the paper, a majority of these studies have come from the NIMH childhood schizophrenia sample, so it is nice to see findings being replicated in independent samples.

The sample size is small when divided in subgroups, but they do find significant frontal gray matter (GM) loss in schizophrenia, not shared by psychotic bipolar patients, as was observed in the NIMH psychotic bipolar sample. This is an important observation in favor of careful diagnostic/phenotypic characterization of patients, as increasing evidence from longitudinal studies seems to suggest that underlying brain pathology and trajectories are quite distinct as well. Interestingly, the "other" psychosis group also showed GM loss, and although we do not have further information on...  Read more

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