title: Cingulum bundle diffusivity and delusions of reference in first episode and chronic schizophrenia.
abstract: The goal of this study was to assess integrity of the cingulum bundle in patients diagnosed with first episode schizophrenia, chronic schizophrenia, and matched controls as well as to determine the relationship between diffusion measures of cingulum bundle integrity and severity of patients' delusions of reference. Participants, who comprised 18 first episode patients, 20 chronic patients, and two groups of matched controls (20 subjects in each), underwent 3 T MRI diffusion tensor imaging. Patients diagnosed with schizophrenia (chronic+first episode) showed decreased fractional anisotropy in the right cingulum bundle compared with controls. First episode patients exhibited higher trace bilaterally, compared with matched controls, and on the left compared with chronic patients. Axial diffusivity was increased in first episode patients, bilaterally, compared with matched controls and chronic patients. Radial diffusivity was also higher, bilaterally, in first episode patients compared with matched controls, and on the right compared with chronic patients. Trace diffusity and radial diffusivity in first episode patients were significantly correlated with increased severity of delusions of reference. Given that the abnormalities were present only in first episode patients and were not observed in chronic cases, it appears that they normalize over time. These abnormalities in first episode patients involved diffusivity measures in all directions (trace, radial and axial), suggesting a likely acute, partially reversible process in which there is an increase in brain water content, i.e., swelling, edema, or inflammation, that may reflect an early neuroinflammatory response in first episode patients.
authors.affiliation: Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women׳s Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: jfitzsimmons@bwh.harvard.edu.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Fitzsimmons
authors.affiliation: Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women׳s Hospital, Harvard Medical School, Boston, MA, USA; Wyle Integrated Science and Engineering Group, Houston, TX, USA.
authors.forename: Jason S
authors.initials: JS
authors.lastname: Schneiderman
authors.affiliation: Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women׳s Hospital, Harvard Medical School, Boston, MA, USA; School of Psychology, University of New South Wales, Sydney, NSW, Australia.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Whitford
authors.affiliation: Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women׳s Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Tali
authors.initials: T
authors.lastname: Swisher
authors.affiliation: Cognitive Neuroscience Laboratory, Veterans Affairs Boston Healthcare System, Brockton Division, Brockton, MA; USA.
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Niznikiewicz
authors.affiliation: Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women׳s Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Paula E
authors.initials: PE
authors.lastname: Pelavin
authors.affiliation: Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women׳s Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Douglas P
authors.initials: DP
authors.lastname: Terry
authors.affiliation: Beth Israel Deaconess Medical Center-Massachusetts Mental Health Center, Public Psychiatry Division, Harvard Medical School, Boston, MA; USA.
authors.forename: Raquelle I
authors.initials: RI
authors.lastname: Mesholam-Gately
authors.affiliation: Beth Israel Deaconess Medical Center-Massachusetts Mental Health Center, Public Psychiatry Division, Harvard Medical School, Boston, MA; USA.
authors.forename: Larry J
authors.initials: LJ
authors.lastname: Seidman
authors.affiliation: Beth Israel Deaconess Medical Center-Massachusetts Mental Health Center, Public Psychiatry Division, Harvard Medical School, Boston, MA; USA; Division of Women׳s Health, Connors Center for Women׳s Health & Gender Biology, Departments of Psychiatry and Medicine, Brigham and Women׳s Hospital, Harvard Medical School, Boston, MA; USA.
authors.forename: Jill M
authors.initials: JM
authors.lastname: Goldstein
authors.affiliation: Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women׳s Hospital, Harvard Medical School, Boston, MA, USA; Surgical Planning Laboratory, MRI Division, Department of Radiology, Brigham and Women׳s Hospital, Harvard Medical School, Boston, MA; USA.
authors.forename: Marek
authors.initials: M
authors.lastname: Kubicki
mesh_terms: D000328:Adult; D016880:Anisotropy; D001921:Brain / Q000473:pathology*; D001931:Brain Mapping; D002908:Chronic Disease; D003337:Corpus Callosum / Q000473:pathology*; D003702:Delusions / Q000209:etiology / Q000473:pathology*; D056324:Diffusion Tensor Imaging; D005260:Female; D006179:Gyrus Cinguli / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012559:Schizophrenia / Q000150:complications / Q000473:pathology*
keywords: Delusions; Diffusion tensor imaging; MRI; Schizophrenia