Progressive and interrelated functional and structural evidence of post-onset brain reduction in schizophrenia.

CONTEXT: Progressive brain abnormalities in schizophrenia remain controversial. Evidence of interrelated progressive functional impairment would buttress the case for structural progression. Mismatch negativity (MMN) is reduced in chronic but not first-hospitalized schizophrenia and may index progressive structural changes. OBJECTIVE: To determine whether MMN shows associations with underlying auditory cortex gray matter at first hospitalization and progressive reduction longitudinally. DESIGN: Cross-sectional (first hospitalization) and longitudinal (1.5-year follow-up). SETTING: A private psychiatric hospital. PARTICIPANTS: Protocol entrance: MMN and magnetic resonance imaging at first hospitalization in 20 subjects with schizophrenia, 21 subjects with bipolar disorder with psychosis, and 32 control subjects. Longitudinal electrophysiologic testing: MMN in 16 subjects with schizophrenia, 17 subjects with bipolar disorder, and 20 control subjects. Longitudinal electrophysiologic testing and magnetic resonance imaging: MMN and magnetic resonance imaging in 11 subjects with schizophrenia, 13 subjects with bipolar disorder, and 13 control subjects. At each time point, reported samples were group matched for age, handedness, and parental socioeconomic status. INTERVENTIONS: Electrophysiologic testing and high-resolution structural magnetic resonance imaging. MAIN OUTCOME MEASURES: Mismatch negativity amplitude and Heschl gyrus and planum temporale gray matter volumes.