title: Brain structure abnormalities in first-episode psychosis patients with persistent apathy.
abstract: BACKGROUND
  Apathy is an enduring and debilitating feature related to poor outcome in patients with first-episode psychosis (FEP). The biological underpinnings of apathy are unknown. We tested if FEP patients with persistent apathy (PA) differed from FEP patients without persistent apathy (NPA) in specific brain structure measures in the early phase of illness.
  
  
  METHODS
  A total of 70 Norwegian FEP patients were recruited within 1 year of first adequate treatment. They were defined as having PA (N=18) or NPA (N=52) based on Apathy Evaluation Scale score at baseline and 1 year later. MRI measures of cortical thickness and subcortical structure volumes were compared between the PA and NPA groups.
  
  
  RESULTS
  The PA group had significantly thinner left orbitofrontal cortex and left anterior cingulate cortex. The results remained significant after controlling for depressive symptoms and antipsychotic medication.
  
  
  CONCLUSIONS
  FEP patients with persistent apathy in the early phase of their illness show brain structural changes compared to FEP patients without persistent apathy. The changes are confined to regions associated with motivation, occur early in the disease course and appear selectively in PA patients when both groups are compared to healthy controls.
authors.affiliation: Department of Psychiatric Research, Diakonhjemmet Hospital, 0319 Oslo, Norway; NORMENT and K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, 0424 Oslo, Norway. Electronic address: lynn.morch-johnsen@medisin.uio.no.
authors.forename: Lynn
authors.initials: L
authors.lastname: Mørch-Johnsen
authors.affiliation: Norwegian Institute of Public Health, 0403 Oslo, Norway.
authors.forename: Ragnar
authors.initials: R
authors.lastname: Nesvåg
authors.affiliation: Division of Mental Health and Addiction, Oslo University Hospital, 0424 Oslo, Norway.
authors.forename: Ann
authors.initials: A
authors.lastname: Faerden
authors.affiliation: Department of Psychiatric Research, Diakonhjemmet Hospital, 0319 Oslo, Norway; NORMENT and K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, 0424 Oslo, Norway.
authors.forename: Unn K
authors.initials: UK
authors.lastname: Haukvik
authors.affiliation: Department of Psychiatric Research, Diakonhjemmet Hospital, 0319 Oslo, Norway; NORMENT and K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, 0424 Oslo, Norway.
authors.forename: Kjetil N
authors.initials: KN
authors.lastname: Jørgensen
authors.affiliation: Department of Psychiatric Research, Diakonhjemmet Hospital, 0319 Oslo, Norway; NORMENT and K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, 0424 Oslo, Norway.
authors.forename: Elisabeth H
authors.initials: EH
authors.lastname: Lange
authors.affiliation: NORMENT and K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, 0424 Oslo, Norway; Division of Mental Health and Addiction, Oslo University Hospital, 0424 Oslo, Norway.
authors.forename: Ole A
authors.initials: OA
authors.lastname: Andreassen
authors.affiliation: NORMENT and K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, 0424 Oslo, Norway; Division of Mental Health and Addiction, Oslo University Hospital, 0424 Oslo, Norway.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Melle
authors.affiliation: Department of Psychiatric Research, Diakonhjemmet Hospital, 0319 Oslo, Norway; NORMENT and K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, 0424 Oslo, Norway.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Agartz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D057565:Apathy; D001921:Brain / Q000473:pathology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D016014:Linear Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000473:pathology* / Q000503:physiopathology*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D055815:Young Adult
keywords: Apathy; Cortical thickness; First-episode; Magnetic resonance imaging; Negative symptoms; Psychosis