Workshop on defining the significance of progressive brain change in schizophrenia: December 12, 2008 American College of Neuropsychopharmacology (ACNP) all-day satellite, Scottsdale, Arizona☆ The rapporteurs' report Stefan J. Borgwardt a,b , Chandlee Dickey c,d , Hilleke Hulshoff Pol e , Thomas J. Whitford f, 1 , Lynn E. DeLisi c,d, ⁎ a University Hospital Basel, Psychiatric Outpatient Department, Petersgraben 4, CH-4031 Basel, Switzerland b King's College London, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK c The Brockton Boston VA Healthcare System, Psychiatry,116A, 940 Belmont Avenue, Brockton, Massachusetts, 02301, United States d Harvard Medical School, Boston, Massachusetts USA e The University of Utrecht, Utrecht, The Netherlands f Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, United States article info abstract Article history: Received 23 February 2009 Received in revised form 19 April 2009 Accepted 21 April 2009 Available online 23 May 2009 In 1990 a satellite session of the American College of Neuropsychopharmacology (ACNP) Annual Meeting was held that focused on the question of whether progressive changes in brain structure occur in schizophrenia and this session raised considerable controversy. Eighteen years later, on December 12, 2008, after much data have since accumulated on this topic, a group of approximately 45 researchers gathered after the annual ACNP meeting to participate in a similar workshop on several unresolved questions still remaining: (1) How strong and consistent is the evidence? (2) Is there anatomic specificity to changes and is it disease specific or subject specific? (3) What is the time course? (4) What is the underlying pathophysiology (i.e. is it central to the disease process or is it due to neuroleptic treatment or other epiphenomena? (5) What is its clinical significance? and (6) Are there treatment implications? The day was chaired by Lynn E. DeLisi and co-chaired by Stephen J. Wood. Christos Pantelis and Jeffrey A. Lieberman extensively helped with its planning. The ACNP assisted in its organization as an official satellite of its annual meeting and several pharmaceutical companies provided support with unrestricted educational grants. The following is a summary of the sessions as recounted by rapporteurs whose job was to record as closely as possible the outcome of discussions on the above outlined questions. Published by Elsevier B.V. Keywords: Progression ventricular enlargement brain structure temporal lobe frontal lobe prodrome 1st episode ,schizophrenia 1. Introduction There is a grouping of the so-called “neurodegenerative” diseases, such as Alzheimer's Dementia, or Parkinson's Disease that does not traditionally include schizophrenia. Yet it is becoming apparent that the structural brain anomalies reported in people with chronic schizophrenia are not static and change over time. The illness itself is one with a clinical course that often worsens over time and becomes a lifelong disorder. The following report is about a workshop on progressive brain change (a worsening of brain pathology over time) in schizophrenia and grew out of a desire of the organizers to synthesize together all the data presented at meetings over the last couple of decades and to discuss their overall significance to the clinical entity we call schizophrenia. Schizophrenia Research 112 (2009) 32–45 ☆ Rapporteurs are alphabetically listed. Each equally contributed to this report. ⁎ Corresponding author. E-mail address: DeLisi76@AOL.com (L.E. DeLisi). 1 Tel.: +1 617 525 6119; fax: +1 617 525 6150. 0920-9964/$ – see front matter. Published by Elsevier B.V. doi:10.1016/j.schres.2009.04.025 Contents lists available at ScienceDirect Schizophrenia Research journal homepage: www.elsevier.com/locate/schres