Investigation of white matter abnormalities in first episode psychosis patients with persistent negative symptoms

Hovington, Cindy L.; Bodnar, Michael; Chakravarty, M. Mallar; Joober, Ridha; Malla, Ashok; Lepage, Martín

doi:10.1016/j.pscychresns.2015.06.017

Cited by 23 publications

(14 citation statements)

References 64 publications

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“…The findings of a reduced FA value in the left arcuate fasciculus of patients with prominent treatment resistant negative symptoms as compared with AVH + patients are consistent with studies reporting lower FA in patients with prominent negative symptoms as compared with healthy controls (Hovington et al, 2015). Furthermore, in healthy subjects, studies show that most subjects have leftward lateralization of the arcuate fasciculus (Catani et al, 2007).…”

Section: Discussionsupporting

confidence: 88%

Integrity of the arcuate fasciculus in patients with schizophrenia with auditory verbal hallucinations: A DTI-tractography study

Psomiades

Fonteneau

Mondino

et al. 2016

NeuroImage: Clinical

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Auditory verbal hallucinations (AVH) of schizophrenia are associated with a disrupted connectivity between frontal and temporoparietal language areas. We hypothesized that this dysconnectivity is underpinned by white matter abnormalities in the left arcuate fasciculus, the main fiber bundle connecting speech production and perception areas. We therefore investigated the relationship between AVH severity and the integrity of the arcuate fasciculus measured by diffusion tensor imaging (DTI) tractography in patients with schizophrenia.Thirty-eight patients with treatment-resistant schizophrenia were included: 26 presented with daily severe treatment-resistant AVH, 12 reported prominent negative symptoms and no AVH. Fractional anisotropy (FA) was measured along the length of the left and right anterior arcuate fasciculi and severity of AVH was assessed using P3 PANSS item.FA values were significantly higher in the left arcuate fasciculus in patients with AVH than in no AVH patients (F(1,35) = 3.86; p = 0.05). No difference was observed in the right arcuate fasciculus. There was a significant positive correlation between FA value in the left arcuate fasciculus and the severity of AVH (r = 0.36; p = 0.02). No correlation was observed between FA values and PANSS total score suggesting a specific relationship between AVH severity and the left arcuate fasciculus integrity.These results support the hypothesis of a relationship between left frontotemporal connectivity and AVH in patients with schizophrenia and suggest that whilst a disruption of frontotemporal connectivity might be present to ensure the emergence of AVH, more severe anatomical alterations may prevent the occurrence of AVH in patients with schizophrenia.

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Section: Discussionsupporting

confidence: 88%

Integrity of the arcuate fasciculus in patients with schizophrenia with auditory verbal hallucinations: A DTI-tractography study

Psomiades

Fonteneau

Mondino

et al. 2016

NeuroImage: Clinical

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“…Observed changes within bilateral temporal cortices corroborate previous studies implicating progressive brain changes within the temporal lobes in FEP, 9,10 and further lend support to previous findings from our research group examining the ePNS construct and its unique neuroanatomical correlates. 7,21,22 On the other hand, non-ePNS patients showed a different pattern of CT change over FUP1, with increased CT in left motor areas (i.e., dorsal pre- and post-central gyri), driven by the sPNS subgroup. This CT increase is speculated to occur as a consequence of positive symptoms, which has been supported previously by findings of a positive correlation between post-central gyri-volumes and SAPS scores.…”

Section: Discussionmentioning

confidence: 99%

Age-related cortical thickness trajectories in first episode psychosis patients presenting with early persistent negative symptoms

et al. 2016

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Recent work has clearly established that early persistent negative symptoms (ePNS) can be observed following a first episode of psychosis (FEP), and can negatively affect functional outcome. There is also evidence for cortical changes associated with ePNS. Given that a FEP often occurs during a period of ongoing complex brain development and maturation, neuroanatomical changes may have a specific age-related component. The current study examines cortical thickness (CT) and trajectories with age using longitudinal structural imaging. Structural T1 volumes were acquired at three time points for ePNS (N=21), PNS due to secondary factors (N=31), non-PNS (N=45) patients, and controls (N=48). Images were processed using the CIVET pipeline. Linear mixed models were applied to test for the main effects of (a) group, (b) time, and interactions between (c) time and group membership, and (d) age and group membership. Compared with the non-PNS and secondary PNS patient groups, the ePNS group showed cortical thinning over time in temporal regions and a thickening with age primarily in prefrontal areas. Early PNS patients also had significantly different linear and quadratic age relationships with CT compared with other groups within cingulate, prefrontal, and temporal cortices. The current study demonstrates that FEP patients with ePNS show significantly different CT trajectories with age. Increased CT may be indicative of disruptions in cortical maturation processes within higher-order brain regions. Individuals with ePNS underline a unique subgroup of FEP patients that are differentiated at the clinical level and who exhibit distinct neurobiological patterns compared with their non-PNS peers.

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“…White matter (WM) alterations are widely recognized as the basis for this kind of disconnectivity, [37][38][39] and many findings underscore WM abnormalities since the early stages of schizophrenia. [40][41][42] Previous functional connectivity studies have found alterations in multiple cortical and subcortical regions. [43][44][45][46][47][48][49] Numerous studies have attempted to identify the neural substrates of motivational deficits in schizophrenia, but these studies have not produced consistent findings as to the specific nodes or connections involved.…”

Section: Introductionmentioning

confidence: 99%

“…37,41,42,[53][54][55] Furthermore, lower FA values in the right superior longitudinal fasciculus (SLF), right inferior longitudinal fasciculus (ILF), right arcuate fasciculus (AF), left uncinate fasciculus (UF), right cingulum bundle, inferior fronto-occipital fasciculus and right fornix (FX), were found to correlate with negative symptom severity. 41,[56][57][58][59][60] Although there has been a large support for the disconnectivity model of psychosis, the relationships between WM microstructure and negative symptom domains remain largely unexplored. Findings concerning reduced FA along WM pathways in the reward system are still sparse and abnormalities in the anterior limb of the internal capsule, the anterior thalamic radiation, the FX or the UF were reported.…”

Section: Introductionmentioning

confidence: 99%

Avolition-Apathy and White Matter Connectivity in Schizophrenia: Reduced Fractional Anisotropy Between Amygdala and Insular Cortex

et al. 2017

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The avolition/apathy domain of negative symptoms includes motivation- and pleasure-related impairments. In people with schizophrenia, structural and functional abnormalities were reported in key regions within the motivational reward system, including ventral-tegmental area (VTA), striatum (especially at the level of the nucleus accumbens, NAcc), orbitofrontal cortex (OFC), as well as amygdala (Amy) and insular cortex (IC). However, the association of the reported abnormalities with avoliton-apathy is still controversial. In the present study, we investigated white matter connectivity patterns within these regions, using a probabilistic analysis of diffusion tensor imaging (DTI) data, in male subjects with schizophrenia. Thirty-five male subjects with schizophrenia (SCZ) and 17 male healthy controls (HC) matched for age, underwent DTI. SCZ were evaluated using the Schedule for Deficit Syndrome (SDS), the Positive and Negative Syndrome Scale (PANSS), and the MATRICS Consensus Cognitive Battery (MCCB). Probabilistic tractography was applied to investigate pathways connecting the Amy and the NAcc with the OFC and IC. Reduced fractional anisotropy (FA) was observed in left Amy-ventral anterior IC connections, in SCZ compared with controls. This abnormality was negatively correlated with avolition/apathy but not with expressive deficit scores. SCZ showed also a reduced connectivity index between right NAcc and medial OFC, as compared with controls. Finally, the left NAcc-dorsal anterior IC connectivity index was negatively correlated with working memory scores. Our results indicate that only the avolition/apathy domain of negative symptoms is related to abnormal connectivity in the motivation-related circuits. The findings also demonstrate that distinct alterations underlie cognitive impairment and avolition/apathy.

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Investigation of white matter abnormalities in first episode psychosis patients with persistent negative symptoms

Cited by 23 publications

References 64 publications

Integrity of the arcuate fasciculus in patients with schizophrenia with auditory verbal hallucinations: A DTI-tractography study

Integrity of the arcuate fasciculus in patients with schizophrenia with auditory verbal hallucinations: A DTI-tractography study

Age-related cortical thickness trajectories in first episode psychosis patients presenting with early persistent negative symptoms

Avolition-Apathy and White Matter Connectivity in Schizophrenia: Reduced Fractional Anisotropy Between Amygdala and Insular Cortex

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