Investigation of endophenotypes and prognostic factors in first-episode psychosis: longitudinal study involving clinical, neuropsychology, genetics, neurochemistry and neuroimaging

• Grant number: 09/11349-9
• Support Opportunities: Regular Research Grants
• Start date: January 01, 2010
• End date: December 31, 2012
• Field of knowledge: Health Sciences - Medicine - Psychiatry
• Principal Investigator: Paulo Clemente Sallet
• Grantee: Paulo Clemente Sallet
• Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil

Abstract

Neuroimaging longitudinal studies suggest that morphometric changes observed in schizophrenia show higher progression in the first years after the onset of psychotic symptoms. Although the progressive reduction of brain parenchyma has been associated with worse prognosis, the clinical correlates (involving neurocognition, response to treatment and outcome of the disease) and the genetic and neurochemical bases of these changes are currently the subject of controversy. This study aims to investigate both neuroananatomic and cognitive changes over a period of two years of development in a group of 50 first-episode schizophrenic patients, comparing them to a control group of 50 healthy volunteers. Subjects will be investigated by structural MRI and DTI (Diffusion Tensor Imaging) at baseline and after an interval of 2 years. The clinical evolution will be assessed by means of neurocognitive tests, psychopathological scales and parameters of therapeutic response. Initial and final findings will be compared in order to obtain patterns of progression of clinical and structural abnormalities at this stage of the disease. The clinical (neurocognitive, psychopathology and treatment response) and neuroimaging (MRI and DTI) will be investigated in light of gene polymorphisms and molecular biomarkers (PLA2, GSK3). Additionally, by means of multivariate analysis, we will seek to identify clinical, structural and genetic endophenotypes of relevance in the identification of neurobiological subgroups more homogeneous in the diagnosis, prognosis and more specific therapies. (AU)