Speed of facial affect intensity recognition as an endophenotype of first-episode psychosis and associated limbic-cortical grey matter systems

BackgroundPsychotic disorders are highly heritable such that the unaffected relatives of patients may manifest characteristics, or endophenotypes, that are more closely related to risk genes than the overt clinical condition. Facial affect processing is dependent on a distributed cortico-limbic network that is disrupted in psychosis. This study assessed facial affect processing and related brain structure as a candidate endophenotype of first-episode psychosis (FEP).MethodThree samples comprising 30 FEP patients, 30 of their first-degree relatives and 31 unrelated healthy controls underwent assessment of facial affect processing and structural magnetic resonance imaging (sMRI) data. Multivariate analysis (partial least squares, PLS) was used to identify a grey matter (GM) system in which anatomical variation was associated with variation in facial affect processing speed.ResultsThe groups did not differ in their accuracy of facial affect intensity rating but differed significantly in speed of response, with controls responding faster than relatives, who responded faster than patients. Within the control group, variation in speed of affect processing was significantly associated with variation of GM density in amygdala, lateral temporal cortex, frontal cortex and cerebellum. However, this association between cortico-limbic GM density and speed of facial affect processing was absent in patients and their relatives.ConclusionsSpeed of facial affect processing presents as a candidate endophenotype of FEP. The normal association between speed of facial affect processing and cortico-limbic GM variation was disrupted in FEP patients and their relatives.

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Brain structural abnormalities in first episode psychosis: A multimodal analysis

European Psychiatry ◽

10.1016/s0924-9338(11)72655-4 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 950-950

Author(s):

S. Rigucci ◽

A. Comparelli ◽

A. De Carolis ◽

M.C. Rossi-Espagnet ◽

E. Ambrosi ◽

...

Keyword(s):

Grey Matter ◽

Diffusion Tensor ◽

First Episode Psychosis ◽

Magnetic Resonance Images ◽

Facial Affect ◽

First Episode ◽

Affect Recognition ◽

Facial Affect Recognition ◽

Data Set ◽

Episode Psychosis

IntroductionWhite matter abnormalities play a prominent role in the pathogenesis of schizophrenia. Diffusion tensor imaging (DTI) studies showed a widespread decrease in fractional anisotropy (FA) in psychotic disorders.AimsTo examine white and grey matter abnormalities in first episode psychosis (FEP).MethodsWe obtained T1-weighted and DTI magnetic resonance images (1.5 T) from 8 right-handed drug-naïve FEP patients and 8 healthy controls. The DTI data set was used to calculate FA maps; we carried-out optimized voxel-based morphometry (VBM) analysis of grey matter (GM) and FA maps using SPM2.Patients were assessed with a neuropsychological battery comprising the Trail Making Test, the Stroop Colour Word Test, the Wisconsin Card Sorting Test and a test of Facial Affect recognition.ResultsThe voxelwise analysis showed decreased FA in the superior longitudinal and inferior fronto-occipital fasciculi, bilaterally, and in the left uncinate fasciculus. We observed reduced GM volume in the left frontal cortex (Brodmann areas [BA] 47, 13, 11, 10, and 9) and in right frontal (BA6), temporal (BA34) and occipital (BA 18, 19, and 30) cortex.Neuropsychological assessment showed impaired executive function and deficit in facial affect recognition.ConclusionOur findings showed fronto-temporal disconnectivity in FEP and structural alterations in both cortical and subcortical regions.Neuroanatomical findings are consistent with patients’ neuropsychological performance.Further studies to establish a relationship between white and grey matter disarray on one hand and neuropsychological testing are needed.

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Network Constraints on Longitudinal Grey Matter Changes in First Episode Psychosis

10.1101/2022.01.11.22268989 ◽

2022 ◽

Author(s):

Sidhant Chopra ◽

Stuart Oldham ◽

Ashlea Segal ◽

Alexander Holmes ◽

Kristina Sabaroedin ◽

...

Keyword(s):

Volume Change ◽

Grey Matter ◽

Structural Connectivity ◽

First Episode Psychosis ◽

First Episode ◽

Control Group ◽

Grey Matter Volume ◽

Volume Changes ◽

Matter Volume ◽

Episode Psychosis

Background: Different regions of the brain's grey matter are connected by a complex structural network of white matter fibres which are responsible for the propagation of action potentials and the transport of trophic and other molecules. In neurodegenerative disease, these connections constrain the way in which grey matter volume loss progresses. Here, we investigated whether connectome architecture also shapes the spatial pattern of longitudinal grey matter volume changes attributable to illness and antipsychotic medication in first episode psychosis (FEP). Methods: We conducted a triple-blind randomised placebo-control MRI study where 62 young adults with first episode psychosis received either an atypical antipsychotic or placebo over 6-months. A healthy control group was also recruited. Anatomical MRI scans were acquired at baseline, 3-months and 12-months. Deformation-based morphometry was used to estimate illness-related and antipsychotic-related grey matter volume changes over time. Representative functional and structural brain connectivity patterns were derived from an independent healthy control group using resting-state functional MRI and diffusion-weighted imaging. We used neighbourhood deformation models to predict the extent of brain change in a given area by the changes observed in areas to which it is either structurally connected or functionally coupled. Results: At baseline, we found that empirical illness-related regional volume differences were strongly correlated with predicted differences using a model constrained by structural connectivity weights (ρ = .541; p < .001). At 3-months and 12-months, we also found a strong correlation between longitudinal regional illness-related (ρ > .516; p < .001) and antipsychotic-related volume change (ρ > .591; p < .001) with volumetric changes in structurally connected areas. These correlations were significantly greater than those observed across various null models accounting for lower-order spatial and network properties of the data. Associations between empirical and predicted volume change estimates were much lower for models that only considered binary structural connectivity (all ρ < .376), or which were constrained by inter-regional functional coupling (all ρ < .436). Finally, we found that potential epicentres of volume change emerged posteriorly early in the illness and shifted to the prefrontal cortex by later illness stages. Conclusion: Psychosis- and antipsychotic-related grey matter volume changes are strongly shaped by anatomical brain connectivity. This result is consistent with findings in other neurological disorders and implies that such connections may constrain pathological processes causing brain dysfunction in FEP.

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Lack of progression of brain abnormalities in first-episode psychosis: a longitudinal magnetic resonance imaging study

Psychological Medicine ◽

10.1017/s0033291710002163 ◽

2010 ◽

Vol 41 (8) ◽

pp. 1677-1689 ◽

Cited By ~ 41

Author(s):

M. S. Schaufelberger ◽

J. M. Lappin ◽

F. L. S. Duran ◽

P. G. P. Rosa ◽

R. R. Uchida ◽

...

Keyword(s):

Grey Matter ◽

Temporal Cortex ◽

Imaging Study ◽

Population Based ◽

First Episode Psychosis ◽

First Episode ◽

Grey Matter Volume ◽

Matter Volume ◽

Episode Psychosis ◽

Brain Changes

BackgroundSome neuroimaging studies have supported the hypothesis of progressive brain changes after a first episode of psychosis. We aimed to determine whether (i) first-episode psychosis patients would exhibit more pronounced brain volumetric changes than controls over time and (ii) illness course/treatment would relate to those changes.MethodLongitudinal regional grey matter volume and ventricle:brain ratio differences between 39 patients with first-episode psychosis (including schizophrenia and schizophreniform disorder) and 52 non-psychotic controls enrolled in a population-based case-control study.ResultsWhile there was no longitudinal difference in ventricle:brain ratios between first-episode psychosis subjects and controls, patients exhibited grey matter volume changes, indicating a reversible course in the superior temporal cortex and hippocampus compared with controls. A remitting course was related to reversal of baseline temporal grey matter deficits.ConclusionsOur findings do not support the hypothesis of brain changes indicating a progressive course in the initial phase of psychosis. Rather, some brain volume abnormalities may be reversible, possibly associated with a better illness course.

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Brief psycho-education for caregivers of persons with first episode psychosis

Indian Journal of Positive Psychology ◽

10.15614/ijpp.v9i01.11741 ◽

2018 ◽

Vol 9 (01) ◽

Author(s):

Praful Prabhuappa Kapse ◽

Manisha Kiran

Keyword(s):

First Episode Psychosis ◽

First Episode ◽

Control Group ◽

Episode Psychosis ◽

Study Results ◽

Before And After ◽

Quasi Experimental ◽

Expressed Emotions ◽

Experimental Group ◽

Group Family

Caring for the persons with first episode psychosis is challenging and demanding. It may lead to the increased burden, expressed emotions among the caregivers. The numerous studies have shown that high burden and negative expressed emotions among caregivers can lead to early relapse in the patients with first episode psychosis. To evaluate the effects of the brief psychoeducation on the caregivers burden and expressed emotions. A quasi experimental - before and after with control group research design was adopted for the study. A total of 60 caregivers have participated in the study, of which 30 caregivers in experimental group and 30 caregivers in the control group. Family Burden Interview Schedule (Pai and Kapoor, 1981) and Attitude Questionnaire (Sethi et al., 1981) was used to assess caregiver's burden and expressed emotions. At end of the psychoeducation intervention, burden among caregivers and negative expressed emotions of the caregivers have significantly reduced. The positive expressed emotions have been increased. Study results demonstrates the importance of psychoeducation intervention in reducing the burden and negative expressed emotions.

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Implementation of NAVIGATE Coordinated Specialty Care for First Episode Psychosis: the Michigan Experience

CNS Spectrums ◽

10.1017/s1092852920002928 ◽

2021 ◽

Vol 26 (2) ◽

pp. 177-178

Author(s):

Eric D. Achtyes ◽

Kari Kempema ◽

Zhehui Luo ◽

Katharine N. Thakkar ◽

Catherine Adams ◽

...

Keyword(s):

Mental Health ◽

Clinical Symptoms ◽

The United States ◽

First Episode Psychosis ◽

Specialty Care ◽

First Episode ◽

Control Group ◽

Evidence Based ◽

Block Grant ◽

Episode Psychosis

AbstractStudy ObjectivesCoordinated specialty care (CSC) is widely accepted as an evidence-based treatment for first episode psychosis (FEP). The NAVIGATE intervention from the Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE-ETP) study is a CSC intervention which offers a suite of evidence-based treatments shown to improve engagement and clinical outcomes, especially in those with shorter duration of untreated psychosis (DUP). Coincident with the publication of this study, legislation was passed by the United States Congress in 2014–15 to fund CSC for FEP via a Substance Abuse and Mental Health Services Administration (SAMHSA) block grant set-aside for each state. In Michigan (MI) the management of this grant was delegated to Network180, the community mental health authority in Kent County, with the goal of making CSC more widely available to the 10 million people in MI. Limited research describes the outcomes of implementation of CSC into community practices with no published accounts evaluating the use of the NAVIGATE intervention in a naturalistic setting. We describe the outcomes of NAVIGATE implementation in the state of MI.MethodsIn 2014, 3 centers in MI were selected and trained to provide NAVIGATE CSC for FEP. In 2016 a 4th center was added, and 2 existing centers were expanded to provide additional access to NAVIGATE. Inclusion: age 18–31, served in 1 of 4 FEP centers in MI. Data collection began in 2015 for basic demographics, global illness (CGI q3 mo), hospital/ED use and work/school (SURF q3 mo) and was expanded in 2016 to include further demographics, diagnosis, DUP, vital signs; and in 2018 for clinical symptoms with the modified Colorado Symptom Inventory (mCSI q6 mo), reported via an online portal. This analysis used data until 12/31/19. Mixed effects models adjusted by age, sex and race were used to account for correlated data within patients.ResultsN=283 had useable demographic information and were included in the analysis. Age at enrollment was 21.6 ± 3.0 yrs; 74.2% male; 53.4% Caucasian, 34.6% African American; 12.9 ± 1.7 yrs of education (N=195). 18 mo retention was 67% with no difference by sex or race. CGI scores decreased 20% from baseline (BL) to 18 mo (BL=3.5, N=134; 15–18 mo=2.8, N=60). Service utilization via the SURF was measured at BL (N=172) and 18 mo (N=72): psychiatric hospitalizations occurred in 37% at BL and 6% at 18 mo (p<0.01); ER visits occurred in 40% at BL and 13% at 18 mo (p<0.01). 44% were working or in school at BL and 68% at 18 mo (p<0.01). 21% were on antipsychotics (AP) at BL (N=178) and 85% at 18 mo (N=13) with 8% and 54% on long acting injectable-AP at BL and 18 mo, respectively. Limitations include missing data and lack of a control group.ConclusionThe implementation of the NAVIGATE CSC program for FEP in MI resulted in meaningful clinical improvement for enrollees. Further support could make this evidence-based intervention available to more people with FEP.FundingSupported by funds from the SAMHSA Medicaid State Block Grant set-aside awarded to Network180 (Achtyes, Kempema). The funders had no role in the design of the study, the analysis or the decision to publish the results.

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Differentiating the effect of antipsychotic medication and illness on brain volume reductions in first-episode psychosis: A Longitudinal, Randomised, Triple-blind, Placebo-controlled MRI Study

Neuropsychopharmacology ◽

10.1038/s41386-021-00980-0 ◽

2021 ◽

Author(s):

Sidhant Chopra ◽

Alex Fornito ◽

Shona M. Francey ◽

Brian O’Donoghue ◽

Vanessa Cropley ◽

...

Keyword(s):

Antipsychotic Medication ◽

Brain Volume ◽

First Episode Psychosis ◽

Common Finding ◽

First Episode ◽

Control Group ◽

Grey Matter Volume ◽

Long Term Effects ◽

Significant Group ◽

Episode Psychosis

AbstractChanges in brain volume are a common finding in Magnetic Resonance Imaging (MRI) studies of people with psychosis and numerous longitudinal studies suggest that volume deficits progress with illness duration. However, a major unresolved question concerns whether these changes are driven by the underlying illness or represent iatrogenic effects of antipsychotic medication. In this study, 62 antipsychotic-naïve patients with first-episode psychosis (FEP) received either a second-generation antipsychotic (risperidone or paliperidone) or a placebo pill over a treatment period of 6 months. Both FEP groups received intensive psychosocial therapy. A healthy control group (n = 27) was also recruited. Structural MRI scans were obtained at baseline, 3 months and 12 months. Our primary aim was to differentiate illness-related brain volume changes from medication-related changes within the first 3 months of treatment. We secondarily investigated long-term effects at the 12-month timepoint. From baseline to 3 months, we observed a significant group x time interaction in the pallidum (p < 0.05 FWE-corrected), such that patients receiving antipsychotic medication showed increased volume, patients on placebo showed decreased volume, and healthy controls showed no change. Across the entire patient sample, a greater increase in pallidal grey matter volume over 3 months was associated with a greater reduction in symptom severity. Our findings indicate that psychotic illness and antipsychotic exposure exert distinct and spatially distributed effects on brain volume. Our results align with prior work in suggesting that the therapeutic efficacy of antipsychotic medications may be primarily mediated through their effects on the basal ganglia.

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VARIATION IN GREY MATTER VOLUME WITH DEGREE OF INSIGHT IN FIRST EPISODE PSYCHOSIS AND CHRONIC SCHIZOPHRENIA

Schizophrenia Research ◽

10.1016/j.schres.2010.02.589 ◽

2010 ◽

Vol 117 (2-3) ◽

pp. 340

Author(s):

J. McFarland ◽

D. Cannon ◽

H. Schmidt ◽

M. Ahmed ◽

S. Hehir ◽

...

Keyword(s):

Grey Matter ◽

Chronic Schizophrenia ◽

First Episode Psychosis ◽

First Episode ◽

Grey Matter Volume ◽

Matter Volume ◽

Episode Psychosis

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Improved facial affect recognition in patients with first-episode psychosis

Early Intervention in Psychiatry ◽

10.1111/eip.12738 ◽

2018 ◽

Vol 13 (4) ◽

pp. 977-983 ◽

Cited By ~ 2

Author(s):

Vasilios P. Bozikas ◽

Aikaterini Dardagani ◽

Eleni Parlapani ◽

Evangelos Ntouros ◽

Athanasios Lagoudis ◽

...

Keyword(s):

First Episode Psychosis ◽

Facial Affect ◽

First Episode ◽

Affect Recognition ◽

Facial Affect Recognition ◽

Episode Psychosis

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O5.1. GREY MATTER BRAIN CHANGES IN MEDICATED AND UNMEDICATED FIRST EPISODE PSYCHOSIS: A RANDOMISED PLACEBO-CONTROLLED TRIAL

Schizophrenia Bulletin ◽

10.1093/schbul/sbz021.209 ◽

2019 ◽

Vol 45 (Supplement_2) ◽

pp. S172-S173

Author(s):

Sidhant Chopra ◽

Alex Fornito ◽

Shona Francey ◽

Brian O’Donoghue ◽

Barnaby Nelson ◽

...

Keyword(s):

Grey Matter ◽

Controlled Trial ◽

First Episode Psychosis ◽

First Episode ◽

Episode Psychosis ◽

Brain Changes

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Brain structural correlates of functional capacity in first-episode psychosis

Scientific Reports ◽

10.1038/s41598-020-73553-8 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Erkan Alkan ◽

Geoff Davies ◽

Kathy Greenwood ◽

Simon L. Evans

Keyword(s):

Functional Capacity ◽

Gray Matter Volume ◽

Brain Regions ◽

First Episode Psychosis ◽

First Episode ◽

Control Group ◽

Neural Basis ◽

Antipsychotic Therapy ◽

Brain Volumes ◽

Episode Psychosis

Abstract Impaired functional capacity is a core feature of schizophrenia and presents even in first-episode psychosis (FEP) patients. Impairments in daily functioning tend to persist despite antipsychotic therapy but their neural basis is less clear. Previous studies suggest that volume loss in frontal cortex might be an important contributor, but findings are inconsistent. We aimed to comprehensively investigate the brain structural correlates of functional capacity in FEP using MRI and a reliable objective measure of functioning [University of California, San Diego Performance-Based Skills Assessment (UPSA)]. In a sample of FEP (n = 39) and a well-matched control group (n = 21), we measured cortical thickness, gray matter volume, and white matter tract integrity (fractional anisotropy, FA) within brain regions implicated by previous work. The FEP group had thinner cortex in various frontal regions and fusiform, and reduced FA in inferior longitudinal fasciculus (ILF). In FEP, poorer functional capacity correlated with reduced superior frontal volume and lower FA in left ILF. Importantly, frontal brain volumes and integrity of the ILF were identified as the structural correlates of functional capacity in FEP, controlling for other relevant factors. These findings enhance mechanistic understanding of functional capacity deficits in schizophrenia by specifying the underlying neural correlates. In future, this could help inform intervention strategies.

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