Systematically mapping gray matter abnormal patterns in drug-naive first-episode schizophrenia from childhood to adolescence

Background Schizophrenia originates early in neurodevelopment, underscoring the need to elaborate on anomalies in the still maturing brain of early-onset schizophrenia (EOS). Methods Gray matter (GM) volumes were evaluated in 94 antipsychotic-naive first-episode EOS patients and 100 typically developing (TD) controls. The anatomical profiles of changing GM deficits in EOS were detected using 2-way analyses of variance with diagnosis and age as factors, and its timing was further charted using stage-specific group comparisons. Interregional relationships of GM alterations were established using structural covariance network analyses. Results Antagonistic interaction results suggested dynamic GM abnormalities of the left fusiform gyrus, inferior occipital gyrus, and lingual gyrus in EOS. These regions comprise a dominating part of the ventral stream, a ventral occipitotemporal (vOT) network engaged in early social information processing. GM abnormalities were mainly located in the vOT regions in childhood-onset patients, whereas in the rostral prefrontal cortex (rPFC) in adolescent-onset patients. Moreover, compared with TD controls, patients' GM synchronization with the ventral stream was disrupted in widespread high-order social perception regions including the rPFC and salience network. Conclusions The current findings reveal age-related anatomical abnormalities of the social perception system in pediatric patients with schizophrenia.