Childhood-Onset Schizophrenia

Brain MRI Rescan After 2 Years of Clozapine Maintenance Treatment

Frazier, Jean A. MD
Giedd, Jay N. MD
Kaysen, Debra BS
Albus, Kathleen BA
Hamburger, Susan MA, MS
Alaghband-Rad, Javad MD
Lenane, Marge C. MSW
McKenna, Kathleen MD
Breier, Alan MD
Rapoport, Judith L. MD

Received May 25, 1995; revision received Nov. 28, 1995; accepted Dec. 5, 1995. From the Child Psychiatry Branch and the Experimental Therapeutics Branch, NIMH. Address reprint requests to Dr. Rapoport, Child Psychiatry Branch, NIMH, Bldg. 10, Room 6N240, 10 Center Dr., MSC 1600, Bethesda, MD 20892.
The authors thank Cathy Vaituzis, B.A., Wendy Marsh, B.A., Yolanda Vauss, M.A., and C.T. Gordon, M.D., for help in obtaining the MRI scans.

American Journal of Psychiatry 153(4):p 564-566, April 1996.

Objective

The effect of clozapine on striatal morphology was examined in adolescents with childhood-onset schizophrenia. Method: Eight adolescent patients with onset of psychosis before age 12 and eight matched comparison subjects had initial and 2-year follow-up brain magnetic resonance imaging scans. Basal ganglia and lateral ventricle volumes were measured. The patients were on a clozapine regimen during the 2-year interim. Results: Caudate volume was larger in the patients at the initial scanning, decreased in the patients between scans, and did not differ significantly between the patients and the comparison subjects at the second scanning. Conclusions: Caudate enlargement in patients with childhood-onset schizophrenia who are taking typical neuroleptics appears to be secondary to medication exposure. Rescanning to examine basal ganglia morphology is indicated for these patients when they are taking an atypical neuroleptic.

(Am J Psychiatry 1996; 153:564-566)