Longitudinal loss of gray matter volume in patients with first-episode schizophrenia: DARTEL automated analysis and ROI validation
T. Asami, and S. Bouix, T. Whitford, M. E. Shenton, D. Salisbury, R. McCarley
Volume 59, Pages 986-996
Region of Interest (ROI) longitudinal studies have detected progressive gray matter (GM) volume reductions
in patients with first-episode schizophrenia (FESZ). However, there are only a few longitudinal voxel-based
morphometry (VBM) studies, and these have been limited in ability to detect relationships between volume
loss and symptoms, perhaps because of methodologic issues. Nor have previous studies compared and validated
VBM results with manual Region of Interest (ROI) analysis.
In the present VBM study, high-dimensional warping and individualized baseline-rescan templates were
used to evaluate longitudinal volume changes within subjects and compared with longitudinal manual ROI
analysis on the same subjects. VBM evaluated thirty-three FESZ and thirty-six matched healthy control subjects
(HC) at baseline (cross-sectionally) and longitudinally evaluated 21 FESZ and 23 HC after an average of
1.5 years from baseline scans. Correlation analyses detected the relationship between changes in regional GM
volumes in FESZ and clinical symptoms derived from the Brief Psychiatric Rating Scale, as well as cognitive
function as assessed by the Mini-Mental State Examination.
At baseline, patients with FESZ had significantly smaller GM volume compared to HC in some regions including
the left superior temporal gyrus (STG). On rescan after 1.5 years, patients showed significant GM volume reductions
compared with HC in the left STG including Heschl's gyrus, and in widespread brain neocortical regions of
frontal, parietal, and limbic regions including the cingulate gyrus. FESZ showed an association of positive symptoms
and volume loss in temporal (especially STG) and frontal regions, and negative symptoms and volume loss
in STG and frontal regions.Worse cognitive functionwas linked to widespread volume reduction, in frontal, temporal
and parietal regions. The validation VBM analyses showed results similar to our previous ROI findings for
STG and cingulate gyrus. We conclude FESZ show widespread, progressive GM volume reductions in many
brain regions. Importantly, these reductions are directly associated with a worse clinical course. Congruence
with ROI analyses suggests the promise of this longitudinal VBM methodology.
Asami T, , Bouix S, Whitford T, Shenton ME, Salisbury D, McCarley R. Longitudinal loss of gray matter volume in patients with first-episode schizophrenia: Dartel automated analysis and roi validation. NeuroImage 2012;59:986-996.