Brain size reduced in schizophrenia patients

Medicated and antipsychotic-naive patients with schizophrenia show significant reductions in brain volume, researchers report.

In a meta-analysis of data from 317 published studies, the team found that intracranial and total brain volumes were significantly reduced in schizophrenia patients compared with controls, after accounting for age, gender, duration of illness, and other variables.

The findings suggest "a neurodevelopmental origin to some of the brain volume reductions observed in schizophrenia," say Sander Haijma (University Medical Center Utrecht, the Netherlands) and team.

In total, 9098 patients and 9231 mentally healthy controls participated in the studies, which were published between 1998 and 2012.

The team found that medicated schizophrenia patients (n= 8327) had significant intracranial and total brain volume reductions of 2.0% and 2.6%, respectively, compared with controls.

Antipsychotic-naive patients (n=771) also showed significant intracranial and total brain volume reductions compared with controls, at 1.7% and 2.0%, respectively, although the magnitude of such reductions was less than that in medicated patients.

The greatest volume reductions in schizophrenia patients were observed in gray matter structures, although total gray matter reductions were greater in medicated than antipsychotic-naive patients, at 4.3% versus 3.8%.

The researchers note that a longer duration of illness and higher doses of antipsychotic medication were associated with greater gray matter volume reductions among the patients.

They write in Schizophrenia Bulletin: "On the basis of this meta-analysis including over 8000 medicated and nearly 800 medication-naive patients, the conclusion appears warranted that brain loss in schizophrenia is related to a combination of (early) neurodevelopmental processes - reflected in intracranial volume reduction - and illness progression."

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