Association of cerebral deficits with clinical symptoms in antipsychotic-naive first-episode schizophrenia: an optimized voxel-based morphometry and resting state functional connectivity study.
OBJECTIVE
The purpose of the present study was to characterize the association between clinical symptoms and anatomical and functional cerebral deficits in a relatively large sample of antipsychotic-naive first-episode schizophrenia patients using optimized voxel-based morphometry and resting state functional connectivity analysis.


METHODS
Participants were 68 antipsychotic-naive first-episode schizophrenia patients and 68 matched healthy comparison subjects. Both patients and healthy comparison subjects were scanned using a volumetric three-dimensional spoiled gradient recall sequence and a gradient-echo echo-planar imaging sequence. Psychopathology of first-episode schizophrenia patients was evaluated using the Positive and Negative Syndrome Scale (PANSS). Optimized voxel-based morphometry was used to characterize gray matter deficits in schizophrenia patients. The clinical significance of regional volume reduction was investigated by examining its association with symptoms in patients with first-episode schizophrenia and with alterations in resting state functional connectivity when brain regions with gray matter volume reduction were used as seed areas.


RESULTS
Significantly decreased gray matter volume was observed in schizophrenia patients in the right superior temporal gyrus (Brodmann's area 41), right middle temporal gyrus (Brodmann's area 21), and right anterior cingulate gyrus (Brodmann's area 32). Decreased gray matter volume in these brain regions was related to greater disturbance as shown on PANSS scores for positive symptoms, general psychopathology symptoms, thought disturbance, activation, paranoia, and impulsive aggression as well as total PANSS scores. A positive correlation was observed between PANSS scores for thought disturbance and temporo-putamen connectivity, and negative correlations were found between temporo-precuneus connectivity and total PANSS scores as well as scores for negative symptoms and anergia.


CONCLUSIONS
The findings revealed volume loss in the right superior temporal gyrus, right middle temporal gyrus, and right anterior cingulate gyrus among antipsychotic-naive first-episode schizophrenia patients. In addition, the functional networks involving the right superior temporal gyrus and middle temporal gyrus were associated with clinical symptom severity. No abnormalities were observed in resting state connectivity with regions of identified gray matter deficits.
Lui
Su
S
Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, PR China.
Deng
Wei
W
Huang
Xiaoqi
X
Jiang
Lijun
L
Ma
Xiaohong
X
Chen
Huafu
H
Zhang
Tijiang
T
Li
Xiuli
X
Li
Dongming
D
Zou
Ling
L
Tang
Hehan
H
Zhou
Xiaohong Joe
XJ
Mechelli
Andrea
A
Collier
David A
DA
Sweeney
John A
JA
Li
Tao
T
Gong
Qiyong
Q
D000328:Adult; D001284:Atrophy; D001927:Brain Diseases / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology*; D001931:Brain Mapping; D004292:Dominance, Cerebral / Q000502:physiology; D005260:Female; D006179:Gyrus Cinguli / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009415:Nerve Net / Q000473:pathology / Q000503:physiopathology*; D010296:Parietal Lobe / Q000473:pathology / Q000503:physiopathology; D017397:Prefrontal Cortex / Q000473:pathology / Q000503:physiopathology; D011569:Psychiatric Status Rating Scales; D012016:Reference Values; D012559:Schizophrenia / Q000175:diagnosis / Q000473:pathology* / Q000503:physiopathology*; D012565:Schizophrenic Psychology; D013702:Temporal Lobe / Q000473:pathology / Q000503:physiopathology