The integrity of the white matter in first-episode schizophrenia patients with auditory verbal hallucinations: an atlas-based DTI analysis

Abstract Cognitive impairment is viewed as a core symptom of schizophrenia (SCZ), but its pathophysiological mechanism remains unclear. White matter (WM) disruption is considered to be a central abnormality that may contribute to cognitive impairment in SCZ patients. However, few studies have addressed the association between cognition and WM integrity in never-treated first-episode (NTFE) patients with SCZ. In this study, we used the MATRICS Consensus Cognitive Battery (MCCB) to evaluate cognitive function in NTFE patients (n = 39) and healthy controls (n = 30), and associated it with whole-brain fractional anisotropy (FA) values obtained via voxel-based diffusion tensor imaging. We found that FA was lower in five brain areas of SCZ patients, including the cingulate gyrus, internal capsule, corpus callosum, cerebellum, and brainstem. Compared with the healthy control group, the MCCB’s total score and 8 out of 10 subscores were significantly lower in NTFE patients (all p < 0.001). Moreover, in patients but not healthy controls, the performance in the Trail Making Test was negatively correlated with the FA value in the left cingulate. Our findings provide evidence that WM disconnection is involved in some cognitive impairment in the early course of SCZ.

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Microstructural white matter changes as correlates of impaired frontal task performance in first episode schizophrenia

Schizophrenia Research ◽

10.1016/s0920-9964(03)81102-7 ◽

2003 ◽

Vol 60 (1) ◽

pp. 191 ◽

Cited By ~ 1

Author(s):

M. Carbon ◽

J. Bates ◽

R.M. Bilder ◽

K.O. Lim

Keyword(s):

White Matter ◽

Task Performance ◽

First Episode ◽

White Matter Changes ◽

First Episode Schizophrenia

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White-matter microstructure in previously drug-naive patients with schizophrenia after 6 weeks of treatment

Psychological Medicine ◽

10.1017/s0033291713000238 ◽

2013 ◽

Vol 43 (11) ◽

pp. 2301-2309 ◽

Cited By ~ 55

Author(s):

Q. Wang ◽

C. Cheung ◽

W. Deng ◽

M. Li ◽

C. Huang ◽

...

Keyword(s):

White Matter ◽

Early Phase ◽

Clinical Symptoms ◽

Diffusion Tensor ◽

Disease Process ◽

Anterior Cingulate ◽

First Episode ◽

Drug Naïve ◽

The Right ◽

First Episode Schizophrenia

BackgroundIt is not clear whether the progressive changes in brain microstructural deficits documented in previous longitudinal magnetic resonance imaging (MRI) studies might be due to the disease process or to other factors such as medication. It is important to explore the longitudinal alterations in white-matter (WM) microstructure in antipsychotic-naive patients with first-episode schizophrenia during the very early phase of treatment when relatively ‘free’ from chronicity.MethodThirty-five patients with first-episode schizophrenia and 22 healthy volunteers were recruited. High-resolution diffusion tensor imaging (DTI) was obtained from participants at baseline and after 6 weeks of treatment. A ‘difference map’ for each individual was calculated from the 6-week follow-up fractional anisotropy (FA) of DTI minus the baseline FA. Differences in Positive and Negative Syndrome Scale (PANSS) scores and Global Assessment of Functioning (GAF) scores between baseline and 6 weeks were also evaluated and expressed as a 6-week/baseline ratio.ResultsCompared to healthy controls, there was a significant decrease in absolute FA of WM around the bilateral anterior cingulate gyrus and the right anterior corona radiata of the frontal lobe in first-episode drug-naive patients with schizophrenia following 6 weeks of treatment. Clinical symptoms improved during this period but the change in FA did not correlate with the changes in clinical symptoms or the dose of antipsychotic medication.ConclusionsDuring the early phase of treatment, there is an acute reduction in WM FA that may be due to the effects of antipsychotic medications. However, it is not possible to entirely exclude the effects of underlying progression of illness.

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Childhood traumatic events and types of auditory verbal hallucinations in first-episode schizophrenia patients

Comprehensive Psychiatry ◽

10.1016/j.comppsych.2015.12.003 ◽

2016 ◽

Vol 66 ◽

pp. 17-22 ◽

Cited By ~ 21

Author(s):

Błażej Misiak ◽

Ahmed A. Moustafa ◽

Andrzej Kiejna ◽

Dorota Frydecka

Keyword(s):

Traumatic Events ◽

First Episode ◽

Auditory Verbal Hallucinations ◽

First Episode Schizophrenia

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Anterior cingulate grey-matter deficits and cannabis use in first-episode schizophrenia

The British Journal of Psychiatry ◽

10.1192/bjp.bp.106.024521 ◽

2007 ◽

Vol 190 (3) ◽

pp. 230-236 ◽

Cited By ~ 63

Author(s):

Philip R. Szeszko ◽

Delbert G. Robinson ◽

Serge Sevy ◽

Sanjiv Kumra ◽

Claudia I. Rupp ◽

...

Keyword(s):

White Matter ◽

Healthy Volunteers ◽

Grey Matter ◽

Magnetic Resonance Images ◽

Cannabis Use ◽

Anterior Cingulate ◽

First Episode ◽

History Of ◽

First Episode Schizophrenia ◽

First Episode Of Schizophrenia

BackgroundDespite the high prevalence of cannabis use in schizophrenia, few studies have examined the potential relationship between cannabis exposure and brain structural abnormalities in schizophrenia.AimsTo investigate prefrontal grey and white matter regions in patients experiencing a first episode of schizophrenia with an additional diagnosis of cannabis use or dependence (n=20) compared with similar patients with no cannabis use (n=31) and healthy volunteers (n=56).MethodVolumes of the superior frontal gyrus, anterior cingulate gyrus and orbital frontal lobe were outlined manually from contiguous magnetic resonance images and automatically segmented into grey and white matter.ResultsPatients who used cannabis had less anterior cingulate grey matter compared with both patients who did not use cannabis and healthy volunteers.ConclusionsA defect in the anterior cingulate is associated with a history of cannabis use among patients experiencing a first episode of schizophrenia and could have a role in poor decision-making and in choosing more risky outcomes.

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