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C A HN E T A L
RESULTS
W. CAHN, MD, PhD, N. E. M. van HAREN, PhD, H. E. HULSHOFF POL, PhD, H.G. SCHNACK, PhD,
E. CASPERS, MSc, D. A. J. LAPONDER, MSc, R. S. KAHN, MD, PhD, Rudolf Magnus Institute of Neurosciences,
A greater total brain volume decrease in Department of Psychiatry, University Medical Center Utrecht, The Netherlands
the first year predicted a higher negative
symptom score on PANSS (b (b770.1, Correspondence: Dr Wiepke Cahn, Department of Psychiatry,University Medical Center Utrecht,
t772.51, P0.02)0.02) and a lesser likelihood Heidelberglaan 100, 3584 GX Utrecht,The Netherlands.Tel: 00
0 0 31 30 250 8180;
818 0; fax: 00 31 30 250 5443;
54 43;
of living independently (b (b7 70.01, t wcahn @umcutrecht.nl
email: wcahn@
72.29, P0.03)0.03) at 5-year follow up.
(First received 26 July 2005, final revision 21 February 2006, accepted 22 May 2006)
A greater grey matter volume decrease in
the first year predicted a higher positive symp- A greater lateral ventricle volume schizophrenia (Pantelis et al,
al, 2003). This
tom score (b(b770.09, t7 72.29, P 70.03), increase in the first year predicted a greater study reported progressive grey matter
a higher negative symptom score (b (b770.16, number of met and unmet needs (b (b1.47,
1.47, decrease in very-high-risk individuals who
t773.38, P0.002)
0.002) (Fig. 1a), a lower GAF t2.82,
2.82, P0.009)
0.009) (Fig. 1c) as measured developed a psychotic illness within 12
score (b
(b0.40,
0.40, t2.79,
2.79, P 0.01) and a lesser with the CAN and a lesser likelihood to live months. None the less, whether these early
likelihood of living independently (b(b770.01, independently (b (b7 71.0, t7 72.31, P progressive brain volume changes in
t773.94, P0.001)
0.001) (Fig. 1b) at T5. 0.03) at T5. A greater cerebellar volume prodromal and first-episode schizophrenia
A greater white matter volume increase in decrease in the first year predicted a higher are caused by the disease itself or are a
the first year predicted higher positive symp- negative symptom score (b (b770.79, t consequence of the disease (and its
tom score (b (b0.09,
0.09, t2.29,
2.29, P0.03)
0.03) at T5. 72.24, P0.03)
0.03) at T5. treatment) still remains unanswered. The
Frontal lobe and third ventricle volume treatment of schizophrenia should focus
change did not predict outcome. A greater on slowing this early progressive brain loss,
grey matter (b
(b770.12, t7 72.8, P0.009)
0.009) with the goal of affecting the clinical course
and cerebellar (b (b70.68, t7 72.43, P favourably.
0.02) volume decrease in the first year
predicted a greater increase in the negative REFERENCES
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DISCUSSION
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