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White-matter markers for psychosis in a prospective ultra-high-risk cohort

Published online by Cambridge University Press:  09 November 2009

O. J. N. Bloemen*
Affiliation:
Academic Medical Centre, Department of Psychiatry, Amsterdam, The Netherlands
M. B. de Koning
Affiliation:
Academic Medical Centre, Department of Psychiatry, Amsterdam, The Netherlands
N. Schmitz
Affiliation:
Academic Medical Centre, Department of Psychiatry, Amsterdam, The Netherlands
D. H. Nieman
Affiliation:
Academic Medical Centre, Department of Psychiatry, Amsterdam, The Netherlands
H. E. Becker
Affiliation:
Academic Medical Centre, Department of Psychiatry, Amsterdam, The Netherlands
L. de Haan
Affiliation:
Academic Medical Centre, Department of Psychiatry, Amsterdam, The Netherlands
P. Dingemans
Affiliation:
Academic Medical Centre, Department of Psychiatry, Amsterdam, The Netherlands
D. H. Linszen
Affiliation:
Academic Medical Centre, Department of Psychiatry, Amsterdam, The Netherlands
T. A. M. J. van Amelsvoort
Affiliation:
Academic Medical Centre, Department of Psychiatry, Amsterdam, The Netherlands
*
*Address for correspondence: Dr O. J. N. Bloemen, Department of Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands (Email: o.j.n.bloemen@amc.nl)

Abstract

Background

Subjects at ‘ultra high risk’ (UHR) for developing psychosis have differences in white matter (WM) compared with healthy controls. WM integrity has not yet been investigated in UHR subjects in relation to the development of subsequent psychosis. Hence, we investigated a prospective cohort of UHR subjects comparing whole brain fractional anisotropy (FA) of those later developing psychosis (UHR-P) to those who did not (UHR-NP).

Method

We recruited 37 subjects fulfilling UHR criteria and 10 healthy controls. Baseline 3 Tesla magnetic resonance imaging (MRI) scans and Positive and Negative Syndrome Scale (PANSS) ratings were obtained. UHR subjects were assessed at 9, 18 and 24 months for development of frank psychosis. We compared baseline FA of UHR-P to controls and UHR-NP subjects. Furthermore, we related clinical data to MRI outcome in the patient population.

Results

Of the 37 UHR subjects, 10 had transition to psychosis. UHR-P subjects showed significantly lower FA values than control subjects in medial frontal lobes bilaterally. UHR-P subjects had lower FA values than UHR-NP subjects, lateral to the right putamen and in the left superior temporal lobe. UHR-P subjects showed higher FA values, compared with UHR-NP, in the left medial temporal lobe. In UHR-P, positive PANSS negatively correlated to FA in the left middle temporal lobe. In the total UHR group positive PANSS negatively correlated to FA in the right superior temporal lobe.

Conclusions

UHR subjects who later develop psychosis have differences in WM integrity, compared with UHR subjects who do not develop psychosis and to healthy controls, in brain areas associated with schizophrenia.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2009

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