J Psychiatry Neurosci 2010; 35(5): 229-236
Mohamed El-Sayed, MD, MSC, PhD; R. Grant Steen, PhD; Michele D. Poe, PhD; T. Carter Bethea, MD; Guido Gerig, PhD; Jeffrey Lieberman, MD; Linmarie Sikich, MD
El-Sayed, Steen, Bethea, Gerig, Sikich — Department of Psychiatry; Poe — Frank Porter Graham Child Development Center, University of North Carolina at Chapel Hill, NC; El-Sayed — Department of Psychiatry, Mansoura University, Mansoura, Egypt; Gerig — Departments of Psychiatry, Computer Science and Bioengineering, University of Utah, Salt Lake City, Utah; Lieberman — Department of Psychiatry, Columbia University, New York, NY
Background: We sought to test the hypothesis that deficits in grey matter volume are characteristic of psychotic youth with early-onset schizophrenia-spectrum disorders (EOSS) but not of psychotic youth with early-onset mood disorders (EOMD).
Methods: We used magnetic resonance imaging to examine brain volume in 24 psychotic youth (13 male, 11 female) with EOSS (n = 12) or EOMD (n = 12) and 17 healthy controls (10 male, 7 female). We measured the volume of grey and white matter using an automated segmentation program.
Results: After adjustment for age and intracranial volume, whole brain volume was lower in the EOSS patients than in the healthy controls (p = 0.001) and EOMD patients (p = 0.002). The EOSS patients had a deficit in grey matter volume (p = 0.005), especially in the frontal (p = 0.003) and parietal (p = 0.006) lobes, with no significant differences in white matter volume.
Limitations: The main limitations of our study were its small sample size and the inclusion of patients with depression and mania in the affective group.
Conclusions: Adolescents with EOSS have grey matter deficits compared with healthy controls and psychotic adolescents with EOMD. Our results suggest that grey matter deficits are not generally associated with psychosis but may be specifically associated with schizophrenia. Larger studies with consistent methods are needed to reconcile the contradictory findings among imaging studies involving psychotic youth.
Submitted Apr. 20, 2009; Revised Nov. 5, 2009, Feb. 5, 2010; Accepted Feb. 9, 2010.
Acknowledgments: This study was supported by a National Institute of Mental Health grant (MH53551), University of North Carolina Mental Health and Neuroscience Clinical Research Center (MH MH33127), National Institutes of Health grant (RR00046) from the General Clinical Research Centers program, and National Alliance for Research on Schizophrenia and Affective Disorders. Dr. El-Sayed was supported by a training scholarship from the Egyptian Government. Data from this study were presented at the 2004 American Academy of Child and Adolescent Psychiatry Meeting, Washington, D.C., at the 2004 Society of Biological Psychiatry Convention, New York, NY, and at the 2004 American Psychiatric Association Annual Meeting, New York, NY.
Competing interests: Janssen Pharmaceutical and Eli Lilly donated drugs to the initial treatment study from which participants for the present study were recruited. Dr. Sikich received consultancy fees from Sanofi Aventis; honoraria from the American Academy of Child and Adolescent Psychiatry, Medscape, Physicians Postgraduate Press, the Society for Adolescent Medicine, the North Carolina Psychiatric Association, the North Carolina School Community Health Association, Autism Speaks and IMEDEX for teaching, preparing continuing medical education material or conducting informational talks; payment for manuscript preparation from Physicians Postgraduate Press; and royalties from Lippincott Williams & Wilkins. She is also part of an expert panel at Abt Associates and is under contract with Neuropharm, Curemark, Seaside, Otsuka Research, Bristol Myers Squibb and GlaxoSmithKline as a site investigator for industry-sponsored trials in autism, Fragile X and schizophrenia. Dr. Lieberman has received grant or research funding from Allon, Forest Labs, Merck, Pfizer, AstraZeneca, Bristol-Myers Squibb, GlaxoSmithKline, Janssen and Wyeth. He has served as a consultant for Cephalon, Eli Lilly and Pfizer and as an advisor for Bioline, GlaxoSmithKline, Intracellular Therapies, Eli Lilly, Pierre Fabre, PsychogGenics, Wyeth, Astra Zeneca, Forest Labs, Janssen, Otsuka, and Pfizer. He has been a member of the data safety monitoring board for Solvay. He has not received financial compensation or salary support for his participation in research, consulting or advisory board or data safety monitoring board activities. He holds a patent for the use of secretin in the treatment of autism. None declared for Drs. El-Sayed, Steen, Pie, Bethea and Gerig.
Contributors: Drs. El-Sayed, Poe, Sikich and Lieberman designed the study. Drs. El-Sayed, Sikich and Lieberman acquired and analyzed the data, which Drs. Steen, Poe, Bethea and Gerig also analyzed. Drs. El-Sayed, Steen, Poe, Bethea and Sikich wrote the article, which Drs. Steen, Poe, Bethea, Gerig and Lieberman reviewed. All authors approved the final version submitted for publication.
Correspondence to: Dr. L. Sikich, Department of Psychiatry, University of North Carolina, Chapel Hill NC 27599-7160; fax 919 966-9646; firstname.lastname@example.org