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

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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Positive symptoms and white matter microstructure in never-medicated first episode schizophrenia

Psychological Medicine ◽

10.1017/s003329171000156x ◽

2010 ◽

Vol 41 (8) ◽

pp. 1709-1719 ◽

Cited By ~ 66

Author(s):

V. Cheung ◽

C. P. Y. Chiu ◽

C. W. Law ◽

C. Cheung ◽

C. L. M. Hui ◽

...

Keyword(s):

White Matter ◽

Negative Symptoms ◽

Diffusion Tensor ◽

Structural Connectivity ◽

Anterior Cingulate ◽

Middle Temporal Gyrus ◽

First Episode ◽

Positive Symptoms ◽

Cingulate Gyrus ◽

First Episode Schizophrenia

BackgroundWe investigated cerebral structural connectivity and its relationship to symptoms in never-medicated individuals with first-onset schizophrenia using diffusion tensor imaging (DTI).MethodWe recruited subjects with first episode DSM-IV schizophrenia who had never been exposed to antipsychotic medication (n=34) and age-matched healthy volunteers (n=32). All subjects received DTI and structural magnetic resonance imaging scans. Patients' symptoms were assessed on the Positive and Negative Syndrome Scale. Voxel-based analysis was performed to investigate brain regions where fractional anisotropy (FA) values significantly correlated with symptom scores.ResultsIn patients with first-episode schizophrenia, positive symptoms correlated positively with FA scores in white matter associated with the right frontal lobe, left anterior cingulate gyrus, left superior temporal gyrus, right middle temporal gyrus, right middle cingulate gyrus, and left cuneus. Importantly, FA in each of these regions was lower in patients than controls, but patients with more positive symptoms had FA values closer to controls. We found no significant correlations between FA and negative symptoms.ConclusionsThe newly-diagnosed, neuroleptic-naive patients had lower FA scores in the brain compared with controls. There was positive correlation between FA scores and positive symptoms scores in frontotemporal tracts, including left fronto-occipital fasciculus and left inferior longitudinal fasciculus. This implies that white matter dysintegrity is already present in the pre-treatment phase and that FA is likely to decrease after clinical treatment or symptom remission.

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Extensive White Matter Abnormalities and Clinical Symptoms in Drug-Naive Patients With First-Episode Schizophrenia

The Journal of Clinical Psychiatry ◽

10.4088/jcp.14m09374 ◽

2015 ◽

Vol 77 (02) ◽

pp. 205-211 ◽

Cited By ~ 20

Author(s):

Xiang Yang Zhang ◽

Feng-Mei Fan ◽

Da-Chun Chen ◽

Yun-Long Tan ◽

Shu-Ping Tan ◽

...

Keyword(s):

White Matter ◽

Clinical Symptoms ◽

First Episode ◽

White Matter Abnormalities ◽

Drug Naïve ◽

First Episode Schizophrenia

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The correlation between white matter integrity and pragmatic language processing in first episode schizophrenia

Brain Imaging and Behavior ◽

10.1007/s11682-020-00314-6 ◽

2020 ◽

Author(s):

Agnieszka Pawełczyk ◽

Emila Łojek ◽

Natalia Żurner ◽

Marta Gawłowska-Sawosz ◽

Piotr Gębski ◽

...

Keyword(s):

White Matter ◽

Fractional Anisotropy ◽

Language Processing ◽

Right Hemisphere ◽

Diffusion Tensor ◽

Pragmatic Language ◽

First Episode ◽

Arcuate Fasciculus ◽

The Right ◽

First Episode Schizophrenia

Abstract Objective: Higher-order language disturbances could be the result of white matter tract abnormalities. The study explores the relationship between white matter and pragmatic skills in first-episode schizophrenia. Methods: Thirty-four first-episode patients with schizophrenia and 32 healthy subjects participated in a pragmatic language and Diffusion Tensor Imaging study, where fractional anisotropy of the arcuate fasciculus, corpus callosum and cingulum was correlated with the Polish version of the Right Hemisphere Language Battery. Results: The patients showed reduced fractional anisotropy in the right arcuate fasciculus, left anterior cingulum bundle and left forceps minor. Among the first episode patients, reduced understanding of written metaphors correlated with reduced fractional anisotropy of left forceps minor, and greater explanation of written and picture metaphors correlated with reduced fractional anisotropy of the left anterior cingulum. Conclusions: The white matter dysfunctions may underlie the pragmatic language impairment in schizophrenia. Our results shed further light on the functional neuroanatomical basis of pragmatic language use by patients with schizophrenia.

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Relationships between abnormal neural activities and cognitive impairments in patients with drug-naive first-episode schizophrenia

10.21203/rs.3.rs-15802/v2 ◽

2020 ◽

Author(s):

Wei Yan ◽

Rongrong Zhang ◽

Min Zhou ◽

Shuiping Lu ◽

Wenmei Li ◽

...

Keyword(s):

Cognitive Deficits ◽

Clinical Symptoms ◽

Cognitive Impairments ◽

Clinical Manifestations ◽

Small Sample ◽

First Episode ◽

Adult Intelligence Scale ◽

Drug Naïve ◽

The Right ◽

First Episode Schizophrenia

Abstract Background Prior resting state functional magnetic resonance imaging studies via the regional homogeneity (ReHo) method have demonstrated inconsistent and conflicting results because of several confounding factors, such as small sample size, medicinal influence, and illness duration. Relationships between ReHo measures and cognitive impairments in patients with drug-naive first-episode schizophrenia (dn-FES) are rarely reported. This study was conducted to explore the correlations between ReHo measures, cognitive deficits, and clinical symptoms in patients with dn-FES. Methods A total of 69 patients with dn-FES and 74 healthy controls were recruited. MATRICS Consensus Cognitive Battery (MCCB), Wechsler Adult Intelligence Scale (WAIS), and Positive and Negative Syndrome Scale (PANSS) were used to assess cognitive function, intelligence quotient (IQ), and clinical symptoms, respectively. The correlations between ReHo map and cognitive deficits, the severity of symptoms were examined using strict correlation analyses within brain areas. Results The ReHo values in the right middle frontal gyrus (MFG) and the superior frontal gyrus (SFG) increased in the dn-FES group, whereas the ReHo values in the right cuneus decreased. Correlation analysis showed that the ReHo values in the right MFG were positively correlated with attention/vigilance impairments, social cognition deficits, the severity of clinical manifestations. Conclusions These findings suggested that abnormal spontaneous activities in the right MFG reflect the illness severity and cognitive deficits, which serves as a basis for establishing the objective diagnostic markers and might be a clinical intervention target for patients with schizophrenia.

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Relationships between abnormal neural activities and cognitive impairments in patients with drug-naive first-episode schizophrenia

10.21203/rs.3.rs-15802/v1 ◽

2020 ◽

Author(s):

Wei Yan ◽

Rongrong Zhang ◽

Min Zhou ◽

Shuiping Lu ◽

Wenmei Li ◽

...

Keyword(s):

Cognitive Deficits ◽

Clinical Symptoms ◽

Cognitive Impairments ◽

Clinical Manifestations ◽

Small Sample ◽

First Episode ◽

Adult Intelligence Scale ◽

Drug Naïve ◽

The Right ◽

First Episode Schizophrenia

Abstract Background: Prior resting state functional magnetic resonance imaging studies via the regional homogeneity (ReHo) method have demonstrated inconsistent and conflicting results because of several confounding factors, such as small sample size, medicinal influence, and illness duration. Relationships between ReHo measures and cognitive impairments in patients with drug-naive first-episode schizophrenia (dn-FES) are rarely reported. This study was conducted to explore the correlations between ReHo measures, cognitive deficits, and clinical symptoms in patients with dn-FES. Methods: A total of 69 patients with dn-FES and 74 healthy controls were recruited. MATRICS Consensus Cognitive Battery (MCCB), Wechsler Adult Intelligence Scale (WAIS), and Positive and Negative Syndrome Scale (PANSS) were used to assess cognitive function, intelligence quotient (IQ), and clinical symptoms, respectively. The correlations between ReHo map and cognitive deficits, the severity of symptoms were examined using strict correlation analyses within brain areas.Results: The ReHo values in the right middle frontal gyrus (MFG) and the superior frontal gyrus (SFG) increased in the dn-FES group, whereas the ReHo values in the right cuneus decreased. Correlation analysis showed that the ReHo values in the right MFG were positively correlated with attention/vigilance impairments, social cognition deficits, the severity of clinical manifestations. Conclusions: These findings suggested that abnormal spontaneous activities in the right MFG reflect the illness severity and cognitive deficits, which serves as a basis for establishing the objective diagnostic markers and might be a clinical intervention target for patients with schizophrenia.

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Changes in mild cognitive impairment and its subtypes as seen on diffusion tensor imaging

International Psychogeriatrics ◽

10.1017/s1041610212000270 ◽

2012 ◽

Vol 24 (9) ◽

pp. 1483-1493 ◽

Cited By ~ 12

Author(s):

Senthil Thillainadesan ◽

Wei Wen ◽

Lin Zhuang ◽

John Crawford ◽

Nicole Kochan ◽

...

Keyword(s):

Cognitive Impairment ◽

White Matter ◽

Multiple Testing ◽

Diffusion Tensor ◽

Internal Capsule ◽

Anterior Cingulate ◽

Corona Radiata ◽

Amnestic Mci ◽

Subcortical Regions ◽

The Right

ABSTRACTBackground: Previous studies using diffusion tensor imaging (DTI) have observed microstructural abnormalities in white matter regions in both Alzheimer's disease and mild cognitive impairment (MCI). The aim of this work was to examine the abnormalities in white matter and subcortical regions of MCI and its subtypes in a large, community-dwelling older aged cohortMethods: A community-based sample of 396 individuals without dementia underwent medical assessment, neuropsychiatric testing, and neuroimaging. Of these, 158 subjects were classified as MCI and 238 as cognitively normal (controls) based on international MCI consensus criteria. Regional fractional anisotropy (FA) and mean diffusivity (MD) measures were calculated from the DTI and compared between groups. The false discovery rate correction was applied for multiple testing.Results: Subjects with MCI did not have significant differences in FA compared with controls after correction for multiple testing, but had increased MD in the right putamen, right anterior limb of the internal capsule, genu and splenium of the corpus callosum, right posterior cingulate gyrus, left superior frontal gyrus, and right and left corona radiata. When compared with controls, changes in left anterior cingulate, left superior frontal gyrus, and right corona radiata were associated with amnestic MCI (aMCI), whereas changes in the right putamen, right anterior limb of the internal capsule, and the right corona radiata were associated with non-amnestic MCI (naMCI). On logistic regression, the FA values in the left superior gyrus and MD values in the anterior cingulate distinguished aMCI from naMCI.Conclusions: MCI is associated with changes in white matter and subcortical regions as seen on DTI. Changes in some anterior brain regions distinguish aMCI from naMCI.

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Abnormalities of EEG Microstates In Drug-Naïve, First-Episode Schizophrenia

10.21203/rs.3.rs-1042706/v1 ◽

2021 ◽

Author(s):

Qiaoling Sun ◽

Linlin Zhao ◽

Liwen Tan

Keyword(s):

Clinical Symptoms ◽

Early Stage ◽

First Episode ◽

Healthy Controls ◽

Brain Functions ◽

Class D ◽

Syndrome Scale ◽

Drug Naïve ◽

Microstate Analysis ◽

First Episode Schizophrenia

Abstract Objective: Microstate analysis is a powerful tool to probe the brain functions, and changes in microstates under electroencephalography (EEG) have been repeatedly reported in patients with schizophrenia. This study aimed to investigate the dynamics of EEG microstates in drug-naïve, first-episode schizophrenia (FE-SCH) and to test the relationship between EEG microstates and clinical symptoms.Methods: Resting-state EEG were recorded for 23 patients with FE-SCH and 23 healthy controls using a 64-channel cap. Three parameters, i.e., contribution, duration, and occurrence, of the four microstate classes were calculated. Group differences in EEG microstates and their clinical symptoms (assessed using the Positive and Negative Syndrome Scale) were analyzed.Results: Compared with healthy controls, patients with FE-SCH showed increased duration, occurrence and contribution of microstate class C and decreased contribution and occurrence of microstate class D. In addition, the score of positive symptoms in PANSS was negatively correlated with the occurrence of microstate D.Conclusions: Our findings showed abnormal patterns of EEG microstates in drug-naïve, first-episode schizophrenia, which might help distinguish individuals with schizophrenia in the early stage and develop early intervention strategies.

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Cognitive deficits and white matter abnormalities in never-treated first-episode schizophrenia

Translational Psychiatry ◽

10.1038/s41398-020-01049-0 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Mi Yang ◽

Shan Gao ◽

Xiangyang Zhang

Keyword(s):

Cognitive Impairment ◽

White Matter ◽

Diffusion Tensor ◽

Internal Capsule ◽

First Episode ◽

Control Group ◽

Pathophysiological Mechanism ◽

Healthy Controls ◽

Healthy Control ◽

First Episode Schizophrenia

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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Risperidone-induced topological alterations of anatomical brain network in first-episode drug-naive schizophrenia patients: a longitudinal diffusion tensor imaging study

Psychological Medicine ◽

10.1017/s0033291716001380 ◽

2016 ◽

Vol 46 (12) ◽

pp. 2549-2560 ◽

Cited By ~ 7

Author(s):

M. Hu ◽

X. Zong ◽

J. Zheng ◽

J. J. Mann ◽

Z. Li ◽

...

Keyword(s):

Diffusion Tensor Imaging ◽

White Matter ◽

Negative Symptoms ◽

Diffusion Tensor ◽

Imaging Study ◽

First Episode ◽

Longitudinal Diffusion ◽

Before And After ◽

Drug Naïve ◽

Diffusion Tensor Imaging Study

BackgroundIt remains unclear whether the topological deficits of the white matter network documented in cross-sectional studies of chronic schizophrenia patients are due to chronic illness or to other factors such as antipsychotic treatment effects. To answer this question, we evaluated the white matter network in medication-naive first-episode schizophrenia patients (FESP) before and after a course of treatment.MethodWe performed a longitudinal diffusion tensor imaging study in 42 drug-naive FESP at baseline and then after 8 weeks of risperidone monotherapy, and compared them with 38 healthy volunteers. Graph theory was utilized to calculate the topological characteristics of brain anatomical network. Patients’ clinical state was evaluated using the Positive and Negative Syndrome Scale (PANSS) before and after treatment.ResultsPretreatment, patients had relatively intact overall topological organizations, and deficient nodal topological properties primarily in prefrontal gyrus and limbic system components such as the bilateral anterior and posterior cingulate. Treatment with risperidone normalized topological parameters in the limbic system, and the enhancement positively correlated with the reduction in PANSS-positive symptoms. Prefrontal topological impairments persisted following treatment and negative symptoms did not improve.ConclusionsDuring the early phase of antipsychotic medication treatment there are region-specific alterations in white matter topological measures. Limbic white matter topological dysfunction improves with positive symptom reduction. Prefrontal deficits and negative symptoms are unresponsive to medication intervention, and prefrontal deficits are potential trait biomarkers and targets for negative symptom treatment development.

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Cingulate Abnormalities Associated with PANSS Negative Scores in First Episode Schizophrenia

Behavioural Neurology ◽

10.1155/2000/913731 ◽

2000 ◽

Vol 12 (1-2) ◽

pp. 93-101 ◽

Cited By ~ 17

Author(s):

Liz Ashton ◽

Anna Barnes ◽

Martin Livingston ◽

David Wyper ◽

The Scottish Schizophrenia Research Group

Keyword(s):

Negative Symptoms ◽

Statistical Parametric Mapping ◽

Biological Marker ◽

Anterior Cingulate ◽

First Episode ◽

Cingulate Gyrus ◽

Regional Cerebral Blood ◽

Schizophrenic Patients ◽

Drug Naïve ◽

First Episode Schizophrenia

There is evidence for the involvement of the cingulate gyrus in schizophrenia. We present details of a Statistical Parametric Mapping (SPM) analysis of SPECT data from the largest study (N= 39) of drug naive schizophrenic patients. The main findings are that there is decreased perfusion in the anterior cingulate during verbal fluency when patients are compared to controls (matched individually by age, gender and father’s social class as determined by occupation) and also that PANSS negative scores correlate negatively with regional cerebral blood flow in the cingulate gyrus (Pearson’s Correlation coefficient ofr= − 0.49 and significancep< 0.005). This suggests that measurement of change of perfusion in this region could be a useful biological marker in assessing the effect of neuroleptics on negative symptoms.

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