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Original Article |

Delayed White Matter Growth Trajectory in Young Nonpsychotic Siblings of Patients With Childhood-Onset Schizophrenia

Nitin Gogtay, MD; Xue Hua, PhD; Reva Stidd, BS; Christina P. Boyle, BS; Suh Lee, BS; Brian Weisinger, BS; Alex Chavez, BS; Jay N. Giedd, MD; Liv Clasen, PhD; Arthur W. Toga, PhD; Judith L. Rapoport, MD; Paul M. Thompson, PhD
Arch Gen Psychiatry. 2012;69(9):875-884. doi:10.1001/archgenpsychiatry.2011.2084.
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Context  Nonpsychotic siblings of patients with childhood-onset schizophrenia (COS) share cortical gray matter abnormalities with their probands at an early age; these normalize by the time the siblings are aged 18 years, suggesting that the gray matter abnormalities in schizophrenia could be an age-specific endophenotype. Patients with COS also show significant white matter (WM) growth deficits, which have not yet been explored in nonpsychotic siblings.

Objective  To study WM growth differences in nonpsychotic siblings of patients with COS.

Design  Longitudinal (5-year) anatomic magnetic resonance imaging study mapping WM growth using a novel tensor-based morphometry analysis.

Setting  National Institutes of Health Clinical Center, Bethesda, Maryland.

Participants  Forty-nine healthy siblings of patients with COS (mean [SD] age, 16.1 [5.3] years; 19 male, 30 female) and 57 healthy persons serving as controls (age, 16.9 [5.3] years; 29 male, 28 female).

Intervention  Magnetic resonance imaging.

Main Outcome Measure  White matter growth rates.

Results  We compared the WM growth rates in 3 age ranges. In the youngest age group (7 to <14 years), we found a significant difference in growth rates, with siblings of patients with COS showing slower WM growth rates in the parietal lobes of the brain than age-matched healthy controls (false discovery rate, q = 0.05; critical P = .001 in the bilateral parietal WM; a post hoc analysis identified growth rate differences only on the left side, critical P = .004). A growth rate difference was not detectable at older ages. In 3-dimensional maps, growth rates in the siblings even appeared to surpass those of healthy individuals at later ages, at least locally in the brain, but this effect did not survive a multiple comparisons correction.

Conclusions  In this first longitudinal study of nonpsychotic siblings of patients with COS, the siblings showed early WM growth deficits, which normalized with age. As reported before for gray matter, WM growth may also be an age-specific endophenotype that shows compensatory normalization with age.

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Figures

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Figure 1. Contrast maps show growth rate differences between siblings of patients with childhood-onset schizophrenia and healthy controls. A, Red areas signify regions with faster growth rates in controls, observed in parietal white matter. B, Significant difference in growth rate was noted in the youngest age group. C and D, Later ages showed no significant differences.

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Figure 2. Mean growth rate maps for healthy controls (CTL), nonpsychotic siblings of patients with childhood-onset schizophrenia (SIB), and group difference maps. Both groups show stereotypical patterns of rapid growth in the white matter, and difference maps are near zero across the whole brain, suggesting similar growth rates. Standard radiologic convention was used to display the images.

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Figure 3. Partial correlation coefficient maps of the age effects (B1). A, Transverse view. B, Sagittal view. C, Coronal view. The correlation coefficient maps show how age affects growth rates in healthy controls, corrected for multiple comparisons inside each brain lobe. In these regions, there is evidence that growth rates slow with age. The color bar shows the annual rate of change in the growth rate (as a percentage) per year. As such, the red colors show that the annual growth rate drops by approximately 0.5% to 1% per year. This is in line with common sense because the growth rate should slow as children age. Standard radiologic convention was used to display the images.

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Figure 4. Maps of age effects on growth rates. A, Partial correlation coefficient maps for interaction between age effect and diagnosis in white matter (B4). B, P maps of significance for interaction between age effect and diagnosis in white matter (B4). C, Derived age effects in siblings of patients with childhood-onset schizophrenia (COS) corrected for multiple comparisons inside the white matter of each brain lobe (B1 + B4). White matter growth rates slow with age in nonpsychotic siblings of patients with COS. The color bar shows the annual rate of change in the growth rate (in percentage) per year. The red colors show that the annual growth rate drops by approximately 0.2% to 0.8% per year, less than those in healthy controls. Standard radiologic convention was used to display the images.

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