Brain pathology in first-episode psychosis: magnetization transfer imaging provides additional information to MRI measurements of volume loss.
BACKGROUND
Loss of brain volume in first-episode psychosis can be detected using conventional magnetic resonance imaging (MRI), but subtle changes--not leading to reduction in volume--that may contribute to clinical and cognitive abnormalities, may go undetected. Magnetization transfer imaging (MTI), a technique more sensitive to subtle neuropathological changes than conventional MRI, could yield important information on the extent and nature of structural abnormalities.


METHODS
Forty-eight patients (33 males) from a population-based sample with first-episode psychosis (41 with schizophrenia and 7 with schizoaffective psychosis) and 47 healthy volunteers (27 males) were studied. Differences in magnetization transfer ratio (MTR) and white and grey matter volumes between groups were investigated.


RESULTS
In patients, MTR was reduced in right entorhinal cortex, fusiform, dentate and superior frontal gyri and in left superior frontal and inferior/rostral cingulate gyri. Grey matter volume was reduced in right insula, frontal operculum and middle and superior temporal gyri and in left middle temporal gyrus. Grey matter volume increases were seen in patients in the superior frontal gyrus. White matter volume loss was found adjacent to grey matter loss. In patients MTR was lower in all areas of volumetric differences between groups suggesting that both changes may be related. Similar findings were observed when patients with schizoaffective psychosis were removed from the analysis. The correlations between clinical and MRI parameters did not survive correction for multiple comparisons.


CONCLUSIONS
MTI frontal and temporal abnormalities suggesting neuroaxonal and myelin changes were more extensive in our patients than those detected with conventional MRI. Our findings also suggest that there is regional variation in the severity of structural brain abnormalities.
Price
Gary
G
Institute of Neurology, University College London, Queen Square, London, UK. g.price@ion.ucl.ac.uk
Cercignani
Mara
M
Chu
Elvina M
EM
Barnes
Thomas R E
TR
Barker
Gareth J
GJ
Joyce
Eileen M
EM
Ron
Maria A
MA
D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001921:Brain / Q000473:pathology*; D001931:Brain Mapping; D002540:Cerebral Cortex / Q000473:pathology; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000188:drug therapy / Q000473:pathology*; D012559:Schizophrenia / Q000473:pathology; D055815:Young Adult
D014150:Antipsychotic Agents