Anatomical substrates of cognitive and clinical dimensions in first episode schizophrenia

Acta Psychiatr Scand. 2013 Oct;128(4):261-70. doi: 10.1111/acps.12051. Epub 2012 Dec 9.

Abstract

Objective: To explore gray (GM) and white matter (WM) abnormalities and the relationships with neuropsychopathology in first-episode schizophrenia (FES).

Method: Nineteen patients with first episode of non-affective psychosis and 18 controls underwent a magnetic resonance voxel-based morphometry. Additionally, WM fractional anisotropy (FA) was calculated. For correlative analysis, symptoms and neuropsychological performances were scored by PANSS and by a comprehensive neuropsychological assessment respectively.

Results: Patients showed significantly decreased volume of left temporal lobe and disarray of all major WM tracts. Disorganized PANSS factor was inversely related to left cerebellar GM volume (corrected P = 0.03) and to WM FA of the left cerebellum, inferior fronto-occipital fasciculi (IFOF), and inferior longitudinal fasciculi (corrected P < 0.05). PANSS negative factor was inversely related to FA in the IFOF and superior longitudinal fasciculi (corrected P < 0.05). Impairment in facial emotion identification showed associations with temporo-occipital GM volume decrease (corrected P = 0.003) and WM disarray of superior and middle temporal gyri, anterior thalamic radiation, and superior longitudinal fasciculi (corrected P < 0.05). Speed of processing and visual memory correlated with WM abnormalities in fronto-temporal tracts.

Conclusion: These results confirm how the structural development of key brain regions is related to neuropsychopathological dysfunction in FES, consistently with a neurodevelopmentally derived misconnection syndrome.

Keywords: Positive and Negative Syndrome Scale; first-episode schizophrenia; neuropsychological impairment; tract-based spatial statistics; voxel-based morphometry.

MeSH terms

  • Adult
  • Brain / pathology*
  • Brain / physiopathology*
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Neuropsychological Tests
  • Schizophrenia / pathology*
  • Schizophrenia / physiopathology*
  • Young Adult