Progression of neuroanatomical abnormalities after first-episode of psychosis: A 3-year longitudinal sMRI study. (November 2020)

• Record Type: Journal Article
• Authors: Akudjedu, Theophilus N.; Tronchin, Giulia; McInerney, Shane; Scanlon, Cathy; Kenney, Joanne P.M.; McFarland, John; Barker, Gareth J.; McCarthy, Peter; Cannon, Dara M.; McDonald, Colm; Hallahan, Brian
• Is Part Of: Journal of psychiatric research. Volume 130(2020)
• Page Start: 137
• Page End: 151
• Publication Date: 2020-11
• Subjects: First-episode psychosis -- Schizophrenia -- Structural MRI -- Subcortical structures -- Cortical thickness -- Longitudinal study; Psychiatry -- Periodicals; Mental Disorders -- Periodicals; Maladies mentales -- Périodiques; Psychiatry; Electronic journals; Periodicals; 616.89005
• DOI: 10.1016/j.jpsychires.2020.07.034
• Languages: English
• ISSNs: 0022-3956

Abstract

Abstract: The location, extent and progression of longitudinal morphometric changes after first-episode of psychosis (FEP) remains unclear. We investigated ventricular and cortico-subcortical regions over a 3-year period in FEP patients compared with healthy controls. High resolution 1.5T T1-weighted MR images were obtained at baseline from 28 FEP patients at presentation and 28 controls, and again after 3-years. The longitudinal FreeSurfer pipeline (v.5.3.0) was used for regional volumetric and cortical reconstruction image analyses. Repeated-measures ANCOVA and vertex-wise linear regression analyses compared progressive changes between groups in subcortical structures and cortical thickness respectively. Compared with controls, patients displayed progressively reduced volume of the caudate [F (1, 51)=5.86, p=0.02, Hedges' g=0.66], putamen [F (1, 51)=6.06, p=0.02, g=0.67], thalamus [F (1, 51)=6.99, p=0.01, g=0.72] and increased right lateral ventricular volume [F (1, 51)=4.03, p=0.05], and significantly increased rate of cortical thinning [F (1, 52)=5.11, p=0.028)] at a mean difference of 0.84% [95% CI (0.10, 1.59)] in the left lateral orbitofrontal region over the 3-year period. In patients, greater reduction in putamen volume over time was associated with lower cumulative antipsychotic medication dose (r=0.49, p=0.01), and increasing lateral ventricular volume over time was associated with worsening negative symptoms (r=0.41, p=0.04) and poorer global functioning (r= −0.41, p=0.04). This study demonstrates localised progressive structural abnormalities in the cortico-striato-thalamo-cortical circuit after the onset of psychosis, with increasing ventricular volume noted as a neuroanatomical marker of poorer clinical and functional outcome.