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

V. CHEUNG, C. P. Y. CHIU, C. W. LAW, C. CHEUNG, C. L. M. HUI, Ka Shing Kevin CHAN, P. C. SHAM, M. Y. DENG, K. S. TAI, P.-L. KHONG, G. M. MCALONAN, S.-E. CHUA, E. CHEN

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Abstract

Background. We investigated cerebral structural connectivity and its relationship to symptoms in never-medicated individuals with first-onset schizophrenia using diffusion tensor imaging (DTI).
Method. We 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.
Results. In 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.
Conclusions. The 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. Copyright © 2010 Cambridge University Press.
Original languageEnglish
Pages (from-to)1709-1719
JournalPsychological Medicine
Volume41
Issue number8
DOIs
Publication statusPublished - Aug 2011

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Anisotropy
Schizophrenia
Diffusion Tensor Imaging
Gyrus Cinguli
Temporal Lobe
Antipsychotic Agents
Occipital Lobe
White Matter
Brain
Frontal Lobe
Diagnostic and Statistical Manual of Mental Disorders
Healthy Volunteers
Magnetic Resonance Imaging
Therapeutics

Citation

Cheung, V., Chiu, C. P. Y., Law, C. W., Cheung, C., Hui, C. L. M., Chan, K. K. S., . . . Chen, E. (2011). Positive symptoms and white matter microstructure in never-medicated first episode schizophrenia. Psychological Medicine, 41(8), 1709-1719. doi: 10.1017/S003329171000156X

Keywords

  • Diffusion tensor imaging
  • Drug-naive
  • Fractional anisotropy
  • PANSS
  • Psychosis