Progressive Atrophy of the Frontal Lobes in First-episode Schizophrenia: Interaction with Clinical Course and Neuroleptic Treatment

Objective: This prospective study examined the interaction of clinical course of disease and brain structure with time in schizophrenic patients.

Method: A total of 21 first-episode schizophrenic patients, 10 patients with other psychiatric disorders and a control group of 9 healthy volunteers had CT at first admission and at reinvestigation 5 years later.

Results: At first admission all of the patients had enlarged cortical fissures and sulci compared to controls, and the duration of untreated psychosis was significantly correlated with sulcal enlargement. At reinvestigation, frontal and central brain atrophy had progressed in schizophrenic patients.

Conclusion: The study indicated that ongoing psychosis and lifetime dose of classical antipsychotics were the main candidates accounting for the finding of progressively disturbed brain structure during the first 5 years of schizophrenia.