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Positive symptoms and white matter microstructure in never-medicated first episode schizophrenia

Published online by Cambridge University Press:  01 September 2010

V. Cheung ,
C. P. Y. Chiu ,
C. W. Law ,
C. Cheung ,
C. L. M. Hui ,
K. K. S. Chan ,
P. C. Sham ,
M. Y. Deng ,
K. S. Tai  and
P.-L. Khong
...Show all authors
V. Cheung
Affiliation:
Department of Psychiatry, University of Hong Kong, Pokfulam, SAR China Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hunghom, SAR China
C. P. Y. Chiu
Affiliation:
Department of Psychiatry, University of Hong Kong, Pokfulam, SAR China
C. W. Law
Affiliation:
Department of Psychiatry, University of Hong Kong, Pokfulam, SAR China
C. Cheung
Affiliation:
Department of Psychiatry, University of Hong Kong, Pokfulam, SAR China
C. L. M. Hui
Affiliation:
Department of Psychiatry, University of Hong Kong, Pokfulam, SAR China
K. K. S. Chan
Affiliation:
Department of Psychiatry, University of Hong Kong, Pokfulam, SAR China
P. C. Sham
Affiliation:
Department of Psychiatry, University of Hong Kong, Pokfulam, SAR China State Key Laboratory for Brain and Cognitive Sciences, University of Hong Kong, Pokfulam, SAR China
M. Y. Deng
Affiliation:
Department of Psychiatry, University of Hong Kong, Pokfulam, SAR China M.I.N.D. Institute, University of California, Davis, Medical Center, CA, USA
K. S. Tai
Affiliation:
Department of Diagnostic Radiology, Queen Mary Hospital, Pokfulam, SAR China
P.-L. Khong
Affiliation:
Department of Diagnostic Radiology, Queen Mary Hospital, Pokfulam, SAR China
G. M. McAlonan*
Affiliation:
Department of Psychiatry, University of Hong Kong, Pokfulam, SAR China State Key Laboratory for Brain and Cognitive Sciences, University of Hong Kong, Pokfulam, SAR China
S.-E. Chua
Affiliation:
Department of Psychiatry, University of Hong Kong, Pokfulam, SAR China State Key Laboratory for Brain and Cognitive Sciences, University of Hong Kong, Pokfulam, SAR China
E. Chen
Affiliation:
Department of Psychiatry, University of Hong Kong, Pokfulam, SAR China State Key Laboratory for Brain and Cognitive Sciences, University of Hong Kong, Pokfulam, SAR China
*
*Address for correspondence: G. M. McAlonan, MD, PhD, Department of Psychiatry, The University of Hong Kong, Pokfulam, SAR China. (Email: mcalonan@hku.hk)
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Abstract

Background

We investigated cerebral structural connectivity and its relationship to symptoms in never-medicated individuals with first-onset schizophrenia using diffusion tensor imaging (DTI).

Method

We recruited subjects with first episode DSM-IV schizophrenia who had never been exposed to antipsychotic medication (n=34) and age-matched healthy volunteers (n=32). All subjects received DTI and structural magnetic resonance imaging scans. Patients' symptoms were assessed on the Positive and Negative Syndrome Scale. Voxel-based analysis was performed to investigate brain regions where fractional anisotropy (FA) values significantly correlated with symptom scores.

Results

In patients with first-episode schizophrenia, positive symptoms correlated positively with FA scores in white matter associated with the right frontal lobe, left anterior cingulate gyrus, left superior temporal gyrus, right middle temporal gyrus, right middle cingulate gyrus, and left cuneus. Importantly, FA in each of these regions was lower in patients than controls, but patients with more positive symptoms had FA values closer to controls. We found no significant correlations between FA and negative symptoms.

Conclusions

The newly-diagnosed, neuroleptic-naive patients had lower FA scores in the brain compared with controls. There was positive correlation between FA scores and positive symptoms scores in frontotemporal tracts, including left fronto-occipital fasciculus and left inferior longitudinal fasciculus. This implies that white matter dysintegrity is already present in the pre-treatment phase and that FA is likely to decrease after clinical treatment or symptom remission.

Keywords

Diffusion tensor imagingdrug-naivefractional anisotropyPANSSpsychosis
Type
Original Articles
Information
Psychological Medicine , Volume 41 , Issue 8 , August 2011 , pp. 1709 - 1719
Copyright
Copyright © Cambridge University Press 2010

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