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PMID: 23168990 Published · epublish English Journal Article Meta-Analysis Review

Progressive loss of cortical gray matter in schizophrenia: a meta-analysis and meta-regression of longitudinal MRI studies.

Translational psychiatry ·Vol. 2 ·2012-11-20 ·Pages e190

Vita A, De Peri L, Deste G, Sacchetti E

Abstract

Cortical gray matter deficits have been found in patients with schizophrenia, with evidence of progression over time. The aim of this study was to determine the extent of progressive cortical gray matter volume changes over time in schizophrenia, their site and time of occurrence, and the role of potential moderators of brain changes. English language articles published between 1 January 1983 and 31 March 2012 in the MEDLINE and EMBASE databases were searched. Longitudinal magnetic resonance imaging studies comparing changes in cortical gray matter volume over time between patients with schizophrenia and healthy controls were included. Hedges g was calculated for each study. Analyses were performed using fixed- and random-effects models. A subgroup analysis was run to explore the pattern of brain changes in patients with first-episode schizophrenia. A meta-regression statistic was adopted to investigate the role of potential moderators of the effect sizes (ESs). A total of 19 studies, analyzing 813 patients with schizophrenia and 718 healthy controls, were included. Over time, patients with schizophrenia showed a significantly higher volume loss of total cortical gray matter, left superior temporal gyrus (STG), left anterior STG, left Heschl gyrus, left planum temporale and posterior STG bilaterally. Meta-analysis of first-episode schizophrenic patients showed a more significant pattern of progressive loss of whole cerebral gray matter volume involving the frontal, temporal and parietal lobes, and left Heschl gyrus compared with healthy controls. Clinical, pharmacologic and neuroradiological variables were found to be significant moderators of brain volume changes in patients with schizophrenia. The meta-analysis demonstrates that progressive cortical gray matter changes in schizophrenia occur with regional and temporal specificity. The underlying pathological process appears to be especially active in the first stages of the disease, affects the left hemisphere and the superior temporal structures more and is at least partly moderated by the type of pharmacological treatment received.

MeSH Terms
Antipsychotic Agents/adverse effects Cerebral Cortex/drug effects,pathology Disease Progression Humans Longitudinal Studies Magnetic Resonance Imaging Nerve Fibers, Unmyelinated/drug effects,pathology Organ Size/drug effects Regression Analysis Schizophrenia/drug therapy,pathology
Chemicals
Antipsychotic Agents
Authors & Affiliations
4 authors, click to expand affiliations / ORCID
Vita A
School of Medicine, University of Brescia, Brescia, Italy. [email protected]
De Peri L
Deste G
Sacchetti E
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Article Info
Journal
Translational psychiatry
Abbr.
Transl Psychiatry
ISSN
2158-3188
DOI
10.1038/tp.2012.116
Email
[email protected]
Published
2012-11-20
Epub
2012-00-20
Pages
e190
Language
English
Region
United States
NLM ID
101562664
PMCID
PMC3565772
Subset
IM
Corrections
ErratumIn
-
External Links
PubMed source DOI: 10.1038/tp.2012.116 PMC Full Text View journal details
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