Investigating The Brain Regions Related to Early Onset Psychosis: A Voxel-Based Morphometry Study Considering The Effect of Hereditary Burden and Environmental Risk Factors.

Introduction: Schizophrenia is both a neurodevelopmental and neurodegenerative disorder that manifests a complex spectrum of symptoms, significantly impacting mental health. In early-onset psychosis, similar to adult studies, neuroimaging focuses on ventral prefrontal cortical areas and posterior temporoparietal regions, crucial for understanding the neurodevelopmental mechanisms of these conditions in such drug-naive patients. This enables magnetic resonance imaging to be acquired before significant neurodegenerative changes occur, in contrast to chronic schizophrenia cases. Therefore, our study helps advance understanding of disease mechanisms in this patient population.

Methods: We recruited forty-one subjects (17 females, 24 males; mean age=16 years; age range: 12-17 years) who were diagnosed with first-episode psychosis (FEP). We examined the relationship between gene and environmental risk scores (GERS) and whole-brain gray matter (GM) volumes through voxel-based morphometry (VBM).

Results: We found a positive correlation between GM volumes of the left medial frontal gyrus, right anterior prefrontal cortex, left superior frontal gyrus, left operculum of the inferior frontal gyrus, left superior parietal lobe, and left supramarginal gyrus with the GERS. We found a negative correlation between GM volumes of the left superior frontal gyrus, left cerebellum, and the GERS.

Conclusion: Our findings contribute to the understanding of structural abnormalities associated with schizophrenia, aligning with existing literature highlighting GM changes in frontal, parietal, and temporal cortices, as well as limbic structures. Our study underscores the importance of integrating structural and functional neuroimaging approaches to elucidate the pathophysiology of early-onset schizophrenia, emphasizing regions like the dorsolateral prefrontal cortex, ventrolateral prefrontal cortex, and posterior parietal areas.