Video of the Month

(2016 Dec) Accelerated gray and white matter deterioration with age in schizophrenia.

Areas of reduced gray matter volume in schizophrenia from age 25 to 55 years. Reduced gray matter volume is depicted by light blue to hot (yellow and red) colours. Dark blue areas denote unaffected gray matter volume. Hotter colours represent the areas most severely affected (medial prefrontal cortex, hippocampus, thalamus). Click on the image to start the movie.

Areas of reduced fractional anisotropy in schizophrenia from age 30 to 55 years. White matter showing reduced fractional anisotropy is shown in red/yellow. Light gray areas denote unaffected fractional anisotropy. Click on the image to start the movie.

Summary

Using magnetic resonance imaging data from one of the largest neuroimaging sample to date, namely, the Australian Schizophrenia Research Bank (http://www.schizophreniaresearch.org.au/bank/), we mapped gray matter volume and fractional anisotropy – a well-established imaging measure of white matter integrity, in 326 individuals diagnosed with schizophrenia or schizoaffective disorder and 197 healthy comparison subjects aged 2065 years.

We used polynomial regression to model the influence of age on gray matter volume and fractional anisotropy to determine whether the trajectory of gray and white matter changes in individuals with schizophrenia remain stable, are accelerated, or are diminished with age.

Whole-brain and voxel-wise analyses revealed significant loss of gray matter volume in schizophrenia from young adulthood, which progressively worsened with age. The loss of gray matter volume was primarily circumscribed to frontal and temporal brain regions in early adulthood, gradually progressing to most cortical and subcortical areas with advancing age (Movie 1). In addition, the rate of gray matter loss was significantly faster in schizophrenia until middle age, and then slowed thereafter to a stable rate.

In contrast, significant reductions in fractional anisotropy emerged in schizophrenia only after age 35. These reductions were primarily localized to the corpus callosum before becoming widespread, extending to white matter tracts of all cortical lobes and the cerebellum, as age increased (Movie 2). The rate of age-related fractional anisotropy deterioration with age was constant across the lifespan.

Our findings demonstrate faster age-related gray matter and white matter decline in schizophrenia at distinct age windows. Our findings suggest that schizophrenia is characterized by an initial, rapid rate of gray matter loss that slows in middle life, followed by a deficit in white matter that progressively worsens with age at a constant rate.

Cropley VL, Klauser P, Lenroot RK, Bruggemann J, Sundram S, Bousman C, Pereira A, Di Biase M, Weickert TW, Shannon Weickert C, Pantelis C, Zalesky A (2016). Accelerated gray and white matter deterioration with age in schizophrenia. The American Journal of Psychiatry.

http://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.2016.16050610