The distinguishing intrinsic brain circuitry in treatment-naïve first-episode schizophrenia: Ensemble learning classification

Abstract Objective The insula consists of functionally diverse subdivisions, and each division plays different roles in schizophrenia neuropathology. The current study aimed to investigate the abnormal patterns of dynamic functional connectivity (dFC) of insular subdivisions in schizophrenia and the effect of antipsychotics on these connections. Methods Longitudinal study of the dFC of insular subdivisions was conducted in 42 treatment-naive first-episode patients with schizophrenia at baseline and after 8 weeks of risperidone treatment based on resting-state functional magnetic resonance image (fMRI). Results At baseline, patients showed decreased dFC variance (less variable) between the insular subdivisions and the precuneus, supplementary motor area and temporal cortex, as well as increased dFC variance (more variable) between the insular subdivisions and parietal cortex, compared with healthy controls. After treatment, the dFC variance of the abnormal connections were normalized, which was accompanied by a significant improvement in positive symptoms. Conclusions Our findings highlighted the abnormal patterns of fluctuating connectivity of insular subdivision circuits in schizophrenia and suggested that these abnormalities may be modified after antipsychotic treatment.

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Clozapine v. chlorpromazine in treatment-naive, first-episode schizophrenia: 9-year outcomes of a randomised clinical trial

The British Journal of Psychiatry ◽

10.1192/bjp.bp.110.081471 ◽

2011 ◽

Vol 199 (4) ◽

pp. 281-288 ◽

Cited By ~ 47

Author(s):

Ragy R. Girgis ◽

Michael R. Phillips ◽

Xiaodong Li ◽

Kejin Li ◽

Huiping Jiang ◽

...

Keyword(s):

Health Centre ◽

Randomised Clinical Trial ◽

Clinical State ◽

First Episode ◽

Term Outcome ◽

Long Term Outcome ◽

Antipsychotic Medications ◽

Treatment Naïve ◽

First Episode Schizophrenia ◽

First And Second Generation

BackgroundThe differential effects of so-called ‘first- and second-generation’ antipsychotic medications, when given in the first episode, on the long-term outcome of schizophrenia remain to be elucidated.AimsWe compared the 9-year outcomes of individuals initially randomised to clozapine or chlorpromazine.MethodOne-hundred and sixty individuals with treatment-naive, first-episode schizophrenia or schizophreniform disorder in a mental health centre in Beijing, China were randomised to clozapine or chlorpromazine treatment for up to 2 years, followed by up to an additional 7 years of naturalistic treatment. The primary outcome was remission status for individuals in each group.ResultsIndividuals in both groups spent essentially equal amounts of time in each clinical state over the follow-up time period (remission, 78%; intermediate, 8%; relapse, 14%). There were no significant differences on other measures of illness severity. The clozapine group was more likely than the chlorpromazine group to remain on the medication to which they were originally assigned (26% v. 10%, P = 0.01). There were no significant differences between the two groups on other secondary efficacy outcomes.ConclusionsThese findings support the comparability in effectiveness between antipsychotic medications but with slightly greater tolerability of clozapine in the treatment of first-episode psychosis.

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Extensive brain structural network abnormality in first-episode treatment-naive patients with schizophrenia: morphometrical and covariation study

Psychological Medicine ◽

10.1017/s003329171300319x ◽

2014 ◽

Vol 44 (12) ◽

pp. 2489-2501 ◽

Cited By ~ 13

Author(s):

Z. Chen ◽

W. Deng ◽

Q. Gong ◽

C. Huang ◽

L. Jiang ◽

...

Keyword(s):

Meta Analysis ◽

Inferior Frontal Gyrus ◽

Analysis Of Covariance ◽

First Episode ◽

Syndrome Scale ◽

Postcentral Gyrus ◽

Treatment Naïve ◽

Magnetic Resonance Imaging Mri ◽

And Gender ◽

First Episode Schizophrenia

BackgroundAlterations in gray matter (GM) are commonly observed in schizophrenia. Accumulating studies suggest that the brain changes associated with schizophrenia are distributed rather than focal, involving interconnected networks of areas as opposed to single regions. In the current study we aimed to explore GM volume (GMV) changes in a relatively large sample of treatment-naive first-episode schizophrenia (FES) patients using optimized voxel-based morphometry (VBM) and covariation analysis.MethodHigh-resolution T1-weighted images were obtained using 3.0-T magnetic resonance imaging (MRI) from 86 first-episode drug-naive patients with schizophrenia and 86 age- and gender-matched healthy volunteers. Symptom severity was evaluated using the Positive and Negative Syndrome Scale (PANSS). GMV was assessed using optimized VBM and in 16 regions of interest (ROIs), selected on the basis of a previous meta-analysis. The relationships between GMVs in the ROIs were examined using an analysis of covariance (ANCOVA).ResultsThe VBM analysis revealed that first-episode patients showed reduced GMV in the hippocampus bilaterally. The ROI analysis identified reductions in GMV in the left inferior frontal gyrus, bilateral hippocampus and right thalamus. The ANCOVA revealed different patterns of regional GMV correlations in patients and controls, including of inter- and intra-insula, inter-amygdala and insula–postcentral gyrus connections.ConclusionsSchizophrenia involves regional reductions in GMV and changes in GMV covariance in the insula, amygdala and postcentral gyrus. These findings were evident at the onset of the disorder, before treatment, and therefore cannot be attributable to the effects of chronic illness progression or medication.

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