Intracranial and subcortical volumes in adolescents with <scp>early‐onset</scp> psychosis: A multisite <scp>mega‐analysis</scp> from the <scp>ENIGMA</scp> consortium
Tiril P. Gurholt, Vera Lonning, Stener Nerland, Kjetil Nordbø Jørgensen, Unn K. Haukvik, Clara Alloza, Celso Arango, Cláudia Barth, Carrie E. Bearden, Michael Berk, Hannes Bohman, Orwa Dandash, Covadonga M. Díaz‐Caneja, Carl T. Edbom, Theo G.M. van Erp, Anne‐Kathrin Fett, Sophia Frangou, Benjamin I. Goldstein, Anahit Grigorian, Neda Jahanshad, Anthony James, Joost Janssen, Cecilie Johannessen, Katherine H. Karlsgodt, Matthew J. Kempton, Peter Kochunov, Lydia Krabbendam, Marinos Kyriakopoulos, M. Lundberg, Bradley J. MacIntosh, Bjørn Rishovd Rund, Runar Elle Smelror, Alysha A. Sultan, Christian K. Tamnes, Sophia I. Thomopoulos, Ariana Vajdi, Kirsten Wedervang‐Resell, Anne M. Myhre, Ole A. Andreassen, Paul M. Thompson, Ingrid Agartz, For the ENIGMA‐EOP Working Group
Abstract
Early-onset psychosis disorders are serious mental disorders arising before the age of 18 years. Here, we investigate the largest neuroimaging dataset, to date, of patients with early-onset psychosis and healthy controls for differences in intracranial and subcortical brain volumes. The sample included 263 patients with early-onset psychosis (mean age: 16.4 ± 1.4 years, mean illness duration: 1.5 ± 1.4 years, 39.2% female) and 359 healthy controls (mean age: 15.9 ± 1.7 years, 45.4% female) with magnetic resonance imaging data, pooled from 11 clinical cohorts. Patients were diagnosed with early-onset schizophrenia (n = 183), affective psychosis (n = 39), or other psychotic disorders (n = 41). We used linear mixed-effects models to investigate differences in intracranial and subcortical volumes across the patient sample, diagnostic subgroup and antipsychotic medication, relative to controls. We observed significantly lower intracranial (Cohen's d = -0.39) and hippocampal (d = -0.25) volumes, and higher caudate (d = 0.25) and pallidum (d = 0.24) volumes in patients relative to controls. Intracranial volume was lower in both early-onset schizophrenia (d = -0.34) and affective psychosis (d = -0.42), and early-onset schizophrenia showed lower hippocampal (d = -0.24) and higher pallidum (d = 0.29) volumes. Patients who were currently treated with antipsychotic medication (n = 193) had significantly lower intracranial volume (d = -0.42). The findings demonstrate a similar pattern of brain alterations in early-onset psychosis as previously reported in adult psychosis, but with notably low intracranial volume. The low intracranial volume suggests disrupted neurodevelopment in adolescent early-onset psychosis.