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Brain volume in first-episode schizophrenia: Systematic review and meta-analysis of magnetic resonance imaging studies

  • R. Grant Steen (a1), Courtney Mull (a1), Robert Mcclure (a1), Robert M. Hamer (a1) and Jeffrey A. Lieberman (a1)...
Abstract
Background

Studies of people with schizophrenia assessed using magnetic resonance imaging (MRI) usually include patients with first-episode and chronic disease, yet brain abnormalities may be limited to those with chronic schizophrenia.

Aims

To determine whether patients with a first episode of schizophrenia have characteristic brain abnormalities.

Method

Systematic review and meta-analysis of 66 papers comparing brain volume in patients with a first psychotic episode with volume in healthy controls.

Results

Atotal of 52 cross-sectional studies included 1424 patients with a first psychotic episode; 16 longitudinal studies included 465 such patients. Meta-analysis suggests that whole brain and hippocampal volume are reduced (both P < 0.0001) and that ventricular volume is increased (P < 0.0001) in these patients relative to healthy controls.

Conclusions

Average volumetric changes are close to the limit of detection by MRI methods. It remains to be determined whether schizophrenia is a neurodegenerative process that begins at about the time of symptom onset, or whether it is better characterised as a neurodevelopmental process that produces abnormal brain volumes at an early age.

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Copyright
Corresponding author
Dr R. Grant Steen, Department of Psychiatry, University of North Carolina at Chapel Hill, Campus Box 7160, Chapel Hill, North Carolina 27599-7160, USA. Tel: +1 919 966 8382; e-mail: Grant_Steen@med.unc.edu
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Declaration of interest

None.

Footnotes
References
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Brain volume in first-episode schizophrenia: Systematic review and meta-analysis of magnetic resonance imaging studies

  • R. Grant Steen (a1), Courtney Mull (a1), Robert Mcclure (a1), Robert M. Hamer (a1) and Jeffrey A. Lieberman (a1)...
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