Gray matter abnormalities in a drug resistant patient with early-onset schizophrenia: a case report and review of literature

Abstract Introduction. Neuroimaging studies have shown the presence of structural and functional brain anomalies at different stages of Schizophrenia. Structural and functional abnormalities affect the candidate brain areas for Schizophrenia and are associated with significant cognitive and behavioral impairment. Early-onset schizophrenia (EOS) is associated with poorer outcome if not diagnosed early and treated continuously. Case presentation. We propose a detailed description of the volumetric variations in a 15-year-old female patient with Early-Onset Schizophrenia who developed drug resistance, and an overview of the main structural abnormalities reported in Schizophrenia. Moreover, we discuss the antipsychotic treatment effects and propose the possible consequences of drug resistance. Our clinical case shows a peculiar trend of volumetric variations probably due to drug resistance; furthermore, scientific findings converge on the presence of structural brain abnormalities at any age in Schizophrenia. Conclusion. Based on the available findings so far, it is possible to affirm that, the antipsychotic treatment with atypical neuroleptics (especially if started early and effective on the first episode) might influence the development trajectories of cerebral nervous system in Early-Onset Schizophrenia.