P.1.j.020 Functioning of the posterior cingulate cortex predicts development of insight into one's illness in patients with first-episode psychosis

Objective: The persistent disease burden of psychotic disorders often comes from negative symptoms; however, prognostic biomarkers for negative symptoms have not been fully understood. This study investigated whether the altered functional connectivity of the striatum predicts improvement in negative symptoms and functioning after 1 year of usual treatment in patients with first-episode psychosis. Methods: Resting-state functional magnetic imaging was obtained from 40 first-episode psychosis patients and 40 age- and sex-matched healthy control subjects. Whole-brain functional connectivity maps were generated with subdivisions of the striatum as seed regions and compared between first-episode psychosis patients and healthy controls. In 22 patients with first-episode psychosis, follow-up assessments of negative symptom severity and general functional status were conducted after 1 year of usual treatment. Multiple regression analyses were performed to examine factors predictive of symptomatic or functional improvements over the 1-year period. Results: First-episode psychosis patients showed greater functional connectivity between the left dorsal caudate and left primary motor cortex, as well as between the left ventral rostral putamen and right temporal occipital fusiform cortex, than healthy controls. Lower functional connectivity between the right dorsal rostral putamen and anterior cingulate cortex was observed in the first-episode psychosis patients than in healthy controls. In multiple regression analyses, lower functional connectivity of the left dorsal caudate–left primary motor cortex/right dorsal rostral putamen–anterior cingulate cortex predicted improvement in negative symptoms. In addition, lower right dorsal rostral putamen–anterior cingulate cortex functional connectivity predicted improvement in general functioning. Conclusion: These results suggest that altered striatal functional connectivity can be a potent neurobiological marker in the prognosis prediction of first-episode psychosis. Furthermore, altered striatal functional connectivity may provide a potential target in developing treatments for negative symptoms.

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Anterior cingulate cortex abnormalities associated with a first psychotic episode in bipolar disorder

The British Journal of Psychiatry ◽

10.1192/bjp.bp.107.049205 ◽

2009 ◽

Vol 194 (5) ◽

pp. 426-433 ◽

Cited By ~ 42

Author(s):

Alex Fornito ◽

Murat Yücel ◽

Stephen J. Wood ◽

Andreas Bechdolf ◽

Simon Carter ◽

...

Keyword(s):

Bipolar Disorder ◽

Anterior Cingulate Cortex ◽

Grey Matter ◽

Cingulate Cortex ◽

First Episode Psychosis ◽

Anterior Cingulate ◽

First Episode ◽

Grey Matter Volume ◽

Matter Volume ◽

Episode Psychosis

BackgroundThe anterior cingulate cortex is frequently implicated in the pathophysiology of bipolar disorder, but magnetic resonance imaging (MRI) studies have reported variable findings owing to a reliance on patient samples with chronic illness and to limited appreciation of the region's heterogeneity.AimsTo characterise anterior cingulate cortex abnormalities in patients with bipolar disorder experiencing their first episode of psychosis while accounting for regional anatomical variability.MethodGrey matter volume, surface area and cortical thickness were measured in six anterior cingulate cortex subregions per hemisphere using MRI scans acquired from 26 patients with bipolar I disorder experiencing first-episode psychosis and 26 healthy controls matched for age, gender and regional morphological variability.ResultsRelative to controls, male patients displayed increased thickness in the right subcallosal limbic anterior cingulate cortex. No significant differences were identified in females for grey matter volume or surface area measures. The findings were not attributable to medication effects.ConclusionsThese data suggest that first-episode psychosis in bipolar disorder is associated with a gender-specific, right-lateralised thickness increase in anterior cingulate cortex subregions known to play a role in regulating physiological stress responses.

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Links between central CB1-receptor availability and peripheral endocannabinoids in patients with first episode psychosis

10.1101/664086 ◽

2019 ◽

Cited By ~ 2

Author(s):

Alex M. Dickens ◽

Faith Borgan ◽

Heikki Laurikainen ◽

Santosh Lamichhane ◽

Tiago Marques ◽

...

Keyword(s):

Cannabinoid Receptor ◽

Endocannabinoid System ◽

First Episode Psychosis ◽

Posterior Cingulate Cortex ◽

First Episode ◽

Antipsychotic Treatment ◽

Inverse Association ◽

Positron Emission ◽

Altered Glucose ◽

Episode Psychosis

AbstractThere is an established, albeit poorly-understood link between psychosis and metabolic abnormalities such as altered glucose metabolism and dyslipidemia, which often precede the initiation of antipsychotic treatment. It is known that obesity-associated metabolic disorders are promoted by peripheral activation of the endocannabinoid system (ECS). Our recent data suggest that ECS dysregulation may also play a role in psychosis. With the aim of characterizing the involvement of the central and peripheral ECSs and their mutual associations, here we performed a combined neuroimaging and metabolomic study in patients with first-episode psychosis (FEP) and healthy controls (HC). Regional brain cannabinoid receptor type 1 (CB1R) availability was quantified in two, independent samples of patients with FEP (n=20 and n=8) and HC (n=20 and n=10), by applying 3D positron emission tomography (PET), using two radiotracers, [11C]MePPEP and [18F]FMPEP-d2. Ten endogenous endocannabinoids or related metabolites were quantified in serum, drawn from these individuals during the same imaging session. Circulating levels of arachidonic acid and oleyl ethanolamide were reduced in FEP individuals, but not in those who were predominantly medication-free. In HC, there was an inverse association between levels of circulating arachidonoyl glycerol, anandamide, oleyl ethanolamide and palmitoyl ethanolamide, and CB1R availability in the posterior cingulate cortex. This phenomenon was, however, not observed in FEP patients. Our data thus provide evidence of cross-talk and dysregulation between peripheral endocannabinoids and central CB1R availability in FEP.

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A review of altered biochemistry in the anterior cingulate cortex of first-episode psychosis

Epidemiology and Psychiatric Sciences ◽

10.1017/s2045796016000895 ◽

2017 ◽

Vol 26 (2) ◽

pp. 122-128 ◽

Cited By ~ 3

Author(s):

L. Squarcina ◽

J. A. Stanley ◽

M. Bellani ◽

C. A. Altamura ◽

P. Brambilla

Keyword(s):

Anterior Cingulate Cortex ◽

Psychotic Disorders ◽

Cingulate Cortex ◽

First Episode Psychosis ◽

Anterior Cingulate ◽

First Episode ◽

Resonance Spectroscopy ◽

Chronic Patients ◽

Episode Psychosis

Relevant biochemicals of the brain can be quantified in vivo, non-invasively, using proton Magnetic Resonance Spectroscopy (¹H MRS). This includes metabolites associated with neural general functioning, energetics, membrane phospholipid metabolism and neurotransmission. Moreover, there is substantial evidence of implication of the frontal and prefrontal areas in the pathogenesis of psychotic disorders such as schizophrenia. In particular, the anterior cingulate cortex (ACC) plays an important role in cognitive control of emotional and non-emotional processes. Thus the study of its extent of biochemistry dysfunction in the early stages of psychosis is of particular interest in gaining a greater understanding of its aetiology. In this review, we selected ¹H MRS studies focused on the ACC of first-episode psychosis (FEP). Four studies reported increased glutamatergic levels in FEP, while other four showed preserved concentrations. Moreover, findings on FEP do not fully mirror those in chronic patients. Due to conflicting findings, larger longitudinal ¹H MRS studies are expected to further explore glutamatergic neurotransmission in ACC of FEP in order to have a better understanding of the glutamatergic mechanisms underlying psychosis, possibly using ultra high field MR scanners.

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Longitudinal studies of functional magnetic resonance imaging in first-episode psychosis: A systematic review

European Psychiatry ◽

10.1016/j.eurpsy.2019.04.009 ◽

2019 ◽

Vol 59 ◽

pp. 60-69 ◽

Cited By ~ 3

Author(s):

Carlos González-Vivas ◽

Pau Soldevila-Matías ◽

Olga Sparano ◽

Gracián García-Martí ◽

Luís Martí-Bonmatí ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Systematic Review ◽

Magnetic Resonance ◽

Functional Magnetic Resonance Imaging ◽

Cingulate Cortex ◽

First Episode Psychosis ◽

First Episode ◽

Functional Magnetic Resonance ◽

Resonance Imaging ◽

Episode Psychosis

AbstractBackground:Little is known about changes in brain functioning after first-episode psychosis (FEP). Such knowledge is important for predicting the course of disease and adapting interventions. Functional magnetic resonance imaging has become a promising tool for exploring brain function at the time of symptom onset and at follow-up.Method:A systematic review of longitudinal fMRI studies with FEP patients according to PRISMA guidelines. Resting-state and task-activated studies were considered together.Results:Eleven studies were included. These reported on a total of 236 FEP patients were evaluated by two fMRI scans and clinical assessments. Five studies found hypoactivation at baseline in prefrontal cortex areas, two studies found hypoactivation in the amygdala and hippocampus, and three others found hypoactivation in the basal ganglia. Other hypoactivated areas were the anterior cingulate cortex, thalamus and posterior cingulate cortex. Ten out of eleven studies reported (partial) normalization by increased activation after antipsychotic treatment. A minority of studies observed hyperactivation at baseline.Conclusions:This review of longitudinal FEP samples studies reveals a pattern of predominantly hypoactivation in several brain areas at baseline that may normalize to a certain extent after treatment. The results should be interpreted with caution given the small number of studies and their methodological and clinical heterogeneity.

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Face processing of social cognition in patients with first episode psychosis: Its deficits and association with the right subcallosal anterior cingulate cortex

Schizophrenia Research ◽

10.1016/j.schres.2021.09.027 ◽

2021 ◽

Vol 238 ◽

pp. 99-107

Author(s):

Zui Narita ◽

Kun Yang ◽

Hironori Kuga ◽

Peeraya Piancharoen ◽

Semra Etyemez ◽

...

Keyword(s):

Social Cognition ◽

Anterior Cingulate Cortex ◽

Face Processing ◽

Cingulate Cortex ◽

First Episode Psychosis ◽

Anterior Cingulate ◽

First Episode ◽

Episode Psychosis ◽

The Right

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Association between cannabinoid 1 receptor availability and glutamate levels in healthy controls and drug-free patients with first episode psychosis: a multi-modal PET and 1H-MRS study

European Archives of Psychiatry and Clinical Neuroscience ◽

10.1007/s00406-020-01191-2 ◽

2020 ◽

Author(s):

Faith Borgan ◽

Mattia Veronese ◽

Tiago Reis Marques ◽

David J. Lythgoe ◽

Oliver Howes

Keyword(s):

Anterior Cingulate Cortex ◽

Cingulate Cortex ◽

First Episode Psychosis ◽

Anterior Cingulate ◽

First Episode ◽

Resonance Spectroscopy ◽

Arterial Blood ◽

Cannabinoid 1 Receptor ◽

Episode Psychosis ◽

Drug Naïve

Abstract Cannabinoid 1 receptor and glutamatergic dysfunction have both been implicated in the pathophysiology of schizophrenia. However, it remains unclear if cannabinoid 1 receptor alterations shown in drug-naïve/free patients with first episode psychosis may be linked to glutamatergic alterations in the illness. We aimed to investigate glutamate levels and cannabinoid 1 receptor levels in the same region in patients with first episode psychosis. Forty volunteers (20 healthy volunteers, 20 drug-naïve/free patients with first episode psychosis diagnosed with schizophrenia/schizoaffective disorder) were included in the study. Glutamate levels were measured using proton magnetic resonance spectroscopy. CB1R availability was indexed using the distribution volume (VT (ml/cm3)) of [11C]MePPEP using arterial blood sampling. There were no significant associations between ACC CB1R levels and ACC glutamate levels in controls (R = − 0.24, p = 0.32) or patients (R = − 0.10, p = 0.25). However, ACC glutamate levels were negatively associated with CB1R availability in the striatum (R = − 0.50, p = 0.02) and hippocampus (R = − 0.50, p = 0.042) in controls, but these associations were not observed in patients (p > 0.05). Our findings extend our previous work in an overlapping sample to show, for the first time as far as we’re aware, that cannabinoid 1 receptor alterations in the anterior cingulate cortex are shown in the absence of glutamatergic dysfunction in the same region, and indicate potential interactions between glutamatergic signalling in the anterior cingulate cortex and the endocannabinoid system in the striatum and hippocampus.

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