Introduction: Schizophrenia is a severe disabling disorder with heterogeneous illness courses. In this longitudinal study we characterized schizophrenia patients with poor and good outcome (POS, GOS), using functional and imaging metrics. Patients were defined in accordance to Keefe's criteria (i.e. Kraepelinian and non-Kraepelinian patients). Methods: 35 POS patients, 35 GOS patients and 76 healthy controls (H) underwent clinical, functioning and magnetic resonance imaging (MRI) assessments twice over three years of follow-up. Information on psychopathology, treatment, disability (using the World Health Organization Disability Assessment Scale II, WHO-DAS-2) and prefrontal morphology was collected. Dorsolateral prefrontal cortex (DLPFC) and orbitofrontal cortex (OFC) were manually traced. Results: At baseline, subjects with POS showed significantly decreased right dorsolateral prefrontal cortex (DLPFC) white matter volumes (WM) compared to healthy controls and GOS patients (POS VS HC, p < 0.001; POS vs GOS, p = 0.03), with shrinkage of left DLPFC WM volumes at follow up (t = 2.66, p = 0.01). Also, POS patients had higher disability in respect to GOS subjects both at baseline and after 3 years at theWHO-DAS-2 (p < 0.05). Discussion: Our study supports the hypothesis that POS is characterized by progressive deficits in brain structure and in "real-life" functioning. These are particularly notable in the DLPFC.

Progressive disability and prefrontal shrinkage in schizophrenia patients with poor outcome: a 3-year longitudinal study / N. Dusi, M. Bellani, C. Perlini, L. Squarcina, V. Marinelli, L. Finos, C.A. Altamura, M. Ruggeri, P. Brambilla. - In: SCHIZOPHRENIA RESEARCH. - ISSN 0920-9964. - 179(2017), pp. 104-111. [10.1016/j.schres.2016.09.013]

Progressive disability and prefrontal shrinkage in schizophrenia patients with poor outcome: a 3-year longitudinal study

L. Squarcina;P. Brambilla
2017

Abstract

Introduction: Schizophrenia is a severe disabling disorder with heterogeneous illness courses. In this longitudinal study we characterized schizophrenia patients with poor and good outcome (POS, GOS), using functional and imaging metrics. Patients were defined in accordance to Keefe's criteria (i.e. Kraepelinian and non-Kraepelinian patients). Methods: 35 POS patients, 35 GOS patients and 76 healthy controls (H) underwent clinical, functioning and magnetic resonance imaging (MRI) assessments twice over three years of follow-up. Information on psychopathology, treatment, disability (using the World Health Organization Disability Assessment Scale II, WHO-DAS-2) and prefrontal morphology was collected. Dorsolateral prefrontal cortex (DLPFC) and orbitofrontal cortex (OFC) were manually traced. Results: At baseline, subjects with POS showed significantly decreased right dorsolateral prefrontal cortex (DLPFC) white matter volumes (WM) compared to healthy controls and GOS patients (POS VS HC, p < 0.001; POS vs GOS, p = 0.03), with shrinkage of left DLPFC WM volumes at follow up (t = 2.66, p = 0.01). Also, POS patients had higher disability in respect to GOS subjects both at baseline and after 3 years at theWHO-DAS-2 (p < 0.05). Discussion: Our study supports the hypothesis that POS is characterized by progressive deficits in brain structure and in "real-life" functioning. These are particularly notable in the DLPFC.
Psychosis; Dorsolateral prefrontal cortex; Orbitofrontal cortex; Prefrontal cortex; Magnetic resonance; Disability; Follow-up
Settore MED/25 - Psichiatria
Immune gene expression and white matter pathology in first manic patients beforeand after treatment. A multimodal imaging genetic study
10-set-2016
Article (author)
File in questo prodotto:
File Dimensione Formato  
Dusi_Longitudinal_SR17.pdf

accesso riservato

Tipologia: Publisher's version/PDF
Dimensione 958.41 kB
Formato Adobe PDF
958.41 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
Pubblicazioni consigliate

Caricamento pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/459661
Citazioni
  • ???jsp.display-item.citation.pmc??? 4
  • Scopus 13
  • ???jsp.display-item.citation.isi??? 10
social impact