Diffusion tensor imaging findings in first-episode and chronic schizophrenia patients.
OBJECTIVE
Comparisons of diffusion tensor imaging (DTI) data between first-episode and chronic schizophrenia patients assessed in different studies have led to the suggestion that the decreased fractional anisotropy observed in chronic schizophrenia patients is less pronounced in first-episode patients. However, such comparisons of imaging data generated across studies are susceptible to numerous confounders, which may limit the interpretation of any differences. In order to address these issues and determine whether the DTI abnormalities of chronic schizophrenia are present at illness onset, the authors conducted a DTI investigation of the largest cohort of first-episode schizophrenia patients yet reported in conjunction with a group of chronic schizophrenia patients and healthy subjects for comparison.


METHODS
Fractional anisotropy data generated by diffusion tensor imaging with a 3-T Siemens Allegra head-dedicated MRI system were compared between 40 first-episode schizophrenia patients and 39 age- and gender-matched healthy comparison subjects and between 40 chronic schizophrenia patients and 40 age- and gender-matched healthy comparison subjects. The following regions of interest were assessed: forceps minor (bilaterally), forceps major (bilaterally), inferior longitudinal fasciculus (bilaterally), and the genu and splenium of the corpus callosum.


RESULTS
In most regions, chronic schizophrenia patients showed significant or trend-level lower fractional anisotropy than healthy comparison subjects, whereas the first-episode schizophrenia patients showed only trend-level lower fractional anisotropy in the inferior longitudinal fasciculus.


CONCLUSIONS
The cross-sectional data reported here suggest less widespread changes in white matter at illness onset in schizophrenia which progress in more chronic states. More definitive conclusions will require follow-up imaging of first-episode schizophrenia patients.
Department of Psychiatry, Box 1230, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029, USA. jfriedman1@rcn.com
Joseph I
JI
Friedman
Cheuk
C
Tang
David
D
Carpenter
Monte
M
Buchsbaum
James
J
Schmeidler
Lauren
L
Flanagan
Shana
S
Golembo
Isabella
I
Kanellopoulou
Johnny
J
Ng
Patrick R
PR
Hof
Philip D
PD
Harvey
Nicholas D
ND
Tsopelas
Daniel
D
Stewart
Kenneth L
KL
Davis
D000328:Adult; D000375:Aging; D016880:Anisotropy; D014150:Antipsychotic Agents / Q000627:therapeutic use; D002908:Chronic Disease; D003337:Corpus Callosum / Q000473:pathology; D003710:Demography; D039721:Diagnostic and Statistical Manual of Mental Disorders; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D008297:Male; D012559:Schizophrenia / Q000175:diagnosis* / Q000188:drug therapy
D014150:Antipsychotic Agents