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State-dependent microstructural white matter changes in drug-naïve patients with first-episode psychosis

Published online by Cambridge University Press:  22 August 2017

M. H. Serpa ,
J. Doshi ,
G. Erus ,
T. M. Chaim-Avancini ,
M. Cavallet ,
M. T. van de Bilt ,
P. C. Sallet ,
W. F. Gattaz ,
C. Davatzikos  and
G. F. Busatto
...Show all authors
M. H. Serpa*
Affiliation:
Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Centro de Medicina Nuclear, 3o andar, LIM-21, Rua Dr. Ovídio Pires de Campos, s/n, São Paulo, SP, Brazil Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, Centro de Medicina Nuclear, 3o andar, LIM-21, Rua Dr. Ovídio Pires de Campos, s/n, São Paulo, SP, Brazil Laboratory of Neuroscience, LIM-27, Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Instituto de Psiquiatria, 3o andar, LIM-27, Rua Dr. Ovídio Pires de Campos, s/n, São Paulo, SP, Brazil
J. Doshi
Affiliation:
Section of Biomedical Image Analysis (SBIA), Department of Radiology, University of Pennsylvania, 3600 Market St, Suite 380, Philadelphia, PA, USA
G. Erus
Affiliation:
Section of Biomedical Image Analysis (SBIA), Department of Radiology, University of Pennsylvania, 3600 Market St, Suite 380, Philadelphia, PA, USA
T. M. Chaim-Avancini
Affiliation:
Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Centro de Medicina Nuclear, 3o andar, LIM-21, Rua Dr. Ovídio Pires de Campos, s/n, São Paulo, SP, Brazil Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, Centro de Medicina Nuclear, 3o andar, LIM-21, Rua Dr. Ovídio Pires de Campos, s/n, São Paulo, SP, Brazil
M. Cavallet
Affiliation:
Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Centro de Medicina Nuclear, 3o andar, LIM-21, Rua Dr. Ovídio Pires de Campos, s/n, São Paulo, SP, Brazil Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, Centro de Medicina Nuclear, 3o andar, LIM-21, Rua Dr. Ovídio Pires de Campos, s/n, São Paulo, SP, Brazil
M. T. van de Bilt
Affiliation:
Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, Centro de Medicina Nuclear, 3o andar, LIM-21, Rua Dr. Ovídio Pires de Campos, s/n, São Paulo, SP, Brazil Laboratory of Neuroscience, LIM-27, Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Instituto de Psiquiatria, 3o andar, LIM-27, Rua Dr. Ovídio Pires de Campos, s/n, São Paulo, SP, Brazil
P. C. Sallet
Affiliation:
Laboratory of Neuroscience, LIM-27, Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Instituto de Psiquiatria, 3o andar, LIM-27, Rua Dr. Ovídio Pires de Campos, s/n, São Paulo, SP, Brazil
W. F. Gattaz
Affiliation:
Laboratory of Neuroscience, LIM-27, Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Instituto de Psiquiatria, 3o andar, LIM-27, Rua Dr. Ovídio Pires de Campos, s/n, São Paulo, SP, Brazil
C. Davatzikos
Affiliation:
Section of Biomedical Image Analysis (SBIA), Department of Radiology, University of Pennsylvania, 3600 Market St, Suite 380, Philadelphia, PA, USA
G. F. Busatto
Affiliation:
Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Centro de Medicina Nuclear, 3o andar, LIM-21, Rua Dr. Ovídio Pires de Campos, s/n, São Paulo, SP, Brazil Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, Centro de Medicina Nuclear, 3o andar, LIM-21, Rua Dr. Ovídio Pires de Campos, s/n, São Paulo, SP, Brazil
M. V. Zanetti
Affiliation:
Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Centro de Medicina Nuclear, 3o andar, LIM-21, Rua Dr. Ovídio Pires de Campos, s/n, São Paulo, SP, Brazil Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, Centro de Medicina Nuclear, 3o andar, LIM-21, Rua Dr. Ovídio Pires de Campos, s/n, São Paulo, SP, Brazil Laboratory of Neuroscience, LIM-27, Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Instituto de Psiquiatria, 3o andar, LIM-27, Rua Dr. Ovídio Pires de Campos, s/n, São Paulo, SP, Brazil
*
*Address for correspondence: M. H. Serpa, Centro de Medicina Nuclear, 3° andar, LIM-21/Rua Dr. Ovídio Pires de Campos, s/n, Postal code 05403-010, São Paulo, SP, Brazil. (Email: mauricio.serpa@hc.fm.usp.br)
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Abstract

Background

Diffusion tensor imaging (DTI) studies have consistently shown white matter (WM) microstructural abnormalities in schizophrenia. Whether or not such alterations could vary depending on clinical status (i.e. acute psychosis v. remission) remains to be investigated.

Methods

Twenty-five treatment-naïve first-episode psychosis (FEP) patients and 51 healthy-controls (HC) underwent MRI scanning at baseline. Twenty-one patients were re-scanned as soon as they achieved sustained remission of symptoms; 36 HC were also scanned twice. Rate-of-change maps of longitudinal DTI changes were calculated for in order to examine WM alterations associated with changes in clinical status. We conducted voxelwise analyses of fractional anisotropy (FA) and trace (TR) maps.

Results

At baseline, FEP presented reductions of FA in comparison with HC [p < 0.05, false-discovery rate (FDR)-corrected] affecting fronto-limbic WM and associative, projective and commissural fasciculi. After symptom remission, patients showed FA increase over time (p < 0.001, uncorrected) in some of the above WM tracts, namely the right anterior thalamic radiation, right uncinate fasciculus/inferior fronto-occipital fasciculus, and left inferior fronto-occipital fasciculus/inferior longitudinal fasciculus. We also found significant correlations between reductions in PANSS scores and FA increases over time (p < 0.05, FDR-corrected).

Conclusions

WM changes affecting brain tracts critical to the integration of perceptual information, cognition and emotions are detectable soon after the onset of FEP and may partially reverse in direct relation to the remission of acute psychotic symptoms. Our findings reinforce the view that WM abnormalities in brain tracts are a key neurobiological feature of acute psychotic disorders, and recovery from such WM pathology can lead to amelioration of symptoms.

Keywords

Antipsychoticdiffusion tensor imagingdisease phasefirst-episode psychosisschizophreniawhite matter
Type
Original Articles
Information
Psychological Medicine , Volume 47 , Issue 15 , November 2017 , pp. 2613 - 2627
Copyright
Copyright © Cambridge University Press 2017 

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