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A diffusion tensor imaging study of structural dysconnectivity in never-medicated, first-episode schizophrenia

Published online by Cambridge University Press:  22 October 2007

V. Cheung ,
C. Cheung ,
G. M. McAlonan ,
Y. Deng ,
J. G. Wong ,
L. Yip ,
K. S. Tai ,
P. L. Khong ,
P. Sham  and
S. E. Chua
V. Cheung
Affiliation:
Department of Psychiatry, The University of Hong Kong, Pokfulam, S.A.R.China
C. Cheung
Affiliation:
Department of Psychiatry, The University of Hong Kong, Pokfulam, S.A.R.China
G. M. McAlonan
Affiliation:
Department of Psychiatry, The University of Hong Kong, Pokfulam, S.A.R.China State Key Laboratory for Brain and Cognitive Sciences, The University of Hong Kong, Pokfulam, S.A.R.China
Y. Deng
Affiliation:
Department of Psychiatry, The University of Hong Kong, Pokfulam, S.A.R.China
J. G. Wong
Affiliation:
Department of Psychiatry, The University of Hong Kong, Pokfulam, S.A.R.China
L. Yip
Affiliation:
Department of Radiology, Queen Mary Hospital, Pokfulam, S.A.R.China
K. S. Tai
Affiliation:
Department of Radiology, Queen Mary Hospital, Pokfulam, S.A.R.China
P. L. Khong
Affiliation:
State Key Laboratory for Brain and Cognitive Sciences, The University of Hong Kong, Pokfulam, S.A.R.China Department of Radiology, Queen Mary Hospital, Pokfulam, S.A.R.China
P. Sham
Affiliation:
Department of Psychiatry, The University of Hong Kong, Pokfulam, S.A.R.China State Key Laboratory for Brain and Cognitive Sciences, The University of Hong Kong, Pokfulam, S.A.R.China
S. E. Chua*
Affiliation:
Department of Psychiatry, The University of Hong Kong, Pokfulam, S.A.R.China State Key Laboratory for Brain and Cognitive Sciences, The University of Hong Kong, Pokfulam, S.A.R.China
*
*Address for correspondence: Dr Siew-eng Chua, Department of Psychiatry Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong. (Email: sechua@hku.hk)
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Abstract

Background

Diffusion tensor imaging (DTI) can be used to investigate cerebral structural connectivity in never-medicated individuals with first-episode schizophrenia.

Method

Subjects with first-episode schizophrenia according to DSM-IV-R who had never been exposed to antipsychotic medication (n=25) and healthy controls (n=26) were recruited. Groups were matched for age, gender, best parental socio-economic status and ethnicity. All subjects underwent DTI and structural magnetic resonance imaging (MRI) scans. Voxel-based analysis was performed to investigate brain regions where fractional anisotropy (FA) values differed significantly between groups. A confirmatory region-of-interest (ROI) analysis of FA scores was performed in which regions were placed blind to group membership.

Results

In patients, FA values significantly lower than those in healthy controls were located in the left fronto-occipital fasciculus, left inferior longitudinal fasciculus, white matter adjacent to right precuneus, splenium of corpus callosum, right posterior limb of internal capsule, white matter adjacent to right substantia nigra, and left cerebral peduncle. ROI analysis of the corpus callosum confirmed that the patient group had significantly lower mean FA values than the controls in the splenium but not in the genu. The intra-class correlation coefficient (ICC) for independent ROI measurements was 0.90 (genu) and 0.90 (splenium). There were no regions where FA values were significantly higher in the patients than in the healthy controls.

Conclusions

Widespread structural dysconnectivity, including the subcortical region, is already present in neuroleptic-naive patients in their first episode of illness.

Keywords

Diffusionfirst episodenever medicatedschizophreniastructural
Type
Original Articles
Information
Psychological Medicine , Volume 38 , Issue 6 , June 2008 , pp. 877 - 885
Copyright
Copyright © Cambridge University Press 2007

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