COMPARING TEMPORAL EVENT-CODING IN PATIENTS WITH FIRST EPISODE PSYCHOSIS AND CHRONIC SCHIZOPHRENIA

Abstract Recent diffusion imaging studies using free-water (FW) elimination have shown increased FW in gray matter (GM) and white matter (WM) in first-episode psychosis (FEP) and lower corrected fractional anisotropy (FAt) in WM in chronic schizophrenia. However, little is known about the longitudinal stability and clinical significance of these findings. To determine tissue-specific FW and FAt abnormalities in FEP, as part of a multicenter Spanish study, 132 FEP and 108 healthy controls (HC) were clinically characterized and underwent structural and diffusion-weighted MRI scanning. FEP subjects were classified as schizophrenia spectrum disorder (SSD) or non-SSD. Of these subjects, 45 FEP and 41 HC were longitudinally assessed and rescanned after 2 years. FA and FW tissue-specific measurements were cross-sectional and longitudinally compared between groups using voxel-wise analyses in the skeletonized WM and vertex-wise analyses in the GM surface. SSD and non-SSD subjects showed (a) higher baseline FW in temporal regions and in whole GM average (P.adj(SSD vs HC) = .003, P.adj(Non-SSD vs HC) = .040) and (b) lower baseline FAt in several WM tracts. SSD, but not non-SSD, showed (a) higher FW in several WM tracts and in whole WM (P.adj(SSD vs HC)= .049) and (b) a significant FW decrease over time in temporal cortical regions and in whole GM average (P.adj = .011). Increased extracellular FW in the brain is a reliable finding in FEP, and in SSD appears to decrease over the early course of the illness. FAt abnormalities are stable during the first years of psychosis.

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Plasma monoamines change under dopamine supersensitivity psychosis in patients with schizophrenia: A comparison with first-episode psychosis

Journal of Psychopharmacology ◽

10.1177/0269881119900982 ◽

2020 ◽

Vol 34 (5) ◽

pp. 540-547

Author(s):

Masayuki Takase ◽

Hisoshi Kimura ◽

Nobuhisa Kanahara ◽

Yusuke Nakata ◽

Masaomi Iyo

Keyword(s):

Homovanillic Acid ◽

Chronic Schizophrenia ◽

First Episode Psychosis ◽

First Episode ◽

Antipsychotic Treatment ◽

Blood Concentrations ◽

Dopamine D2 ◽

Schizophrenia Group ◽

Episode Psychosis ◽

Dopamine Supersensitivity

Background: Patients with first-episode psychosis respond well to initial antipsychotic treatment, but among patients experiencing a relapse of psychosis, the response rate falls to approximately 30%. The mechanism of this discrepancy has not been clarified, but the development of dopamine supersensitivity psychosis with the underlying up-regulation of post-synaptic dopamine D2 receptors could be involved in this lesser response. It is uncertain whether elevated dopamine synthesis and release occurs in patients with dopamine supersensitivity psychosis, in contrast to those with first-episode psychosis. Patients and methods: We examined a first-episode psychosis group ( n=6) and a chronic schizophrenia group, i.e. patients experiencing relapse ( n=23) including those who relapsed due to dopamine supersensitivity psychosis ( n=18). Following the initiation of treatment, we measured the patients’ blood concentrations of homovanillic acid and 3-methoxy-4-hydroxyphenylglycol at two weeks and four weeks after the baseline measurements. Results: The first-episode psychosis group tended to show decreased homovanillic acid, accompanied by an improvement of symptoms. The chronic schizophrenia group showed no alteration of homovanillic acid or 3-methoxy-4-hydroxyphenylglycol over the treatment period. These results were the same in the dopamine supersensitivity psychosis patients alone. Conclusions: Our findings suggest that unlike first-episode psychosis, the release of dopamine from presynaptic neurons did not increase in relapse episodes in the patients with dopamine supersensitivity psychosis. This indirectly indicates that the development of supersensitivity of post-synapse dopamine D2 receptor is involved in relapse in dopamine supersensitivity psychosis patients.

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Working memory impairments in first-episode psychosis and chronic schizophrenia

Psychiatry Research ◽

10.1016/j.psychres.2007.10.006 ◽

2009 ◽

Vol 165 (1-2) ◽

pp. 10-18 ◽

Cited By ~ 30

Author(s):

Adriano Zanello ◽

Logos Curtis ◽

Maryse Badan Bâ ◽

Marco C.G. Merlo

Keyword(s):

Working Memory ◽

Chronic Schizophrenia ◽

First Episode Psychosis ◽

First Episode ◽

Memory Impairments ◽

Episode Psychosis

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Very Low-Dose Risperidone in First-Episode Psychosis: A Safe and Effective Way to Initiate Treatment

Schizophrenia Research and Treatment ◽

10.1155/2011/631690 ◽

2011 ◽

Vol 2011 ◽

pp. 1-10 ◽

Cited By ~ 5

Author(s):

Patrick D. McGorry ◽

John Cocks ◽

Paddy Power ◽

Peter Burnett ◽

Susy Harrigan ◽

...

Keyword(s):

Low Dose ◽

Chronic Schizophrenia ◽

First Episode Psychosis ◽

First Episode ◽

Psychotic Episode ◽

Open Label ◽

First Psychotic Episode ◽

Episode Psychosis ◽

Open Label Trial ◽

Risperidone Treatment

Patients experiencing a first psychotic episode have high rates of extrapyramidal symptoms (EPSs) when treated with the doses of neuroleptics used in multiepisode or chronic schizophrenia. There is some evidence that lower doses may be equally, if not more, effective but less toxic in this population. Here, we report the results of a biphasic open label trial designed to assess the efficacy, safety, and tolerability of low-dose (2–4 mg/day) risperidone treatment in a group of 96 first-episode nonaffective psychosis patients. At the end of the trial, 62% of patients met the response criteria although approximately 80% had achieved a response at some time during the study. Reports of EPS remained low, and there were no dystonic reactions. We conclude that even at a dose of 2 mg/day, risperidone was highly effective in reducing acute symptomatology in a real world sample of young first-episode psychosis patients.

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Auditory verbal hallucinations in first episode psychosis – an fMRI symptom capture study

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.2130 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S194-S194

Author(s):

T. Dunne ◽

P. Mallikarjun ◽

M. Broome ◽

B. Farmah ◽

K. Heinze ◽

...

Keyword(s):

Cluster Size ◽

Chronic Schizophrenia ◽

First Episode Psychosis ◽

Self Report ◽

Network Activity ◽

First Episode ◽

Salience Network ◽

Significant Activity ◽

Episode Psychosis ◽

The Right

IntroductionNeurobiological models of auditory verbal hallucination (AVH) have been advanced by symptom capture functional magnetic resonance imaging (fMRI), where participants self-report hallucinations during scanning. To date, regions implicated are those involved with language, memory and emotion. However, previous studies focus on chronic schizophrenia, thus are limited by factors, such as medication use and illness duration. Studies also lack detailed phenomenological descriptions of AVHs. This study investigated the neural correlates of AVHs in patients with first episode psychosis (FEP) using symptom capture fMRI with a rich description of AVHs. We hypothesised that intrusive AVHs would be associated with dysfunctional salience network activity.MethodsSixteen FEP patients with frequent AVH completed four psychometrically validated tools to provide an objective measure of the nature of their AVHs. They then underwent fMRI symptom capture, utilising general linear models analysis to compare activity during AVH to the resting brain.ResultsSymptom capture of AVH was achieved in nine patients who reported intrusive, malevolent and uncontrollable AVHs. Significant activity in the right insula and superior temporal gyrus (cluster size 141 mm3), and the left parahippocampal and lingual gyri (cluster size 121 mm3), P < 0.05 FDR corrected, were recorded during the experience of AVHs.ConclusionsThese results suggest salience network dysfunction (in the right insula) together with memory and language processing area activation in intrusive, malevolent AVHs in FEP. This finding concurs with others from chronic schizophrenia, suggesting these processes are intrinsic to psychosis itself and not related to length of illness or prolonged exposure to antipsychotic medication.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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