title: Two Patterns of White Matter Abnormalities in Medication-Naive Patients With First-Episode Schizophrenia Revealed by Diffusion Tensor Imaging and Cluster Analysis.
abstract: OBJECTIVE
  Accumulating evidence supports the hypothesis that cerebral white matter abnormalities are involved in the pathophysiology of schizophrenia; however, findings from in vivo neuroimaging studies have been inconsistent. Besides confounding factors, including age, illness duration, and medication effects, an additional cause for the inconsistent results may be heterogeneity in the nature of white matter alterations associated with the disorder.
  
  
  OBJECTIVE
  To investigate whether different patterns of white matter abnormalities exist in a large cohort of medication-naive patients with first-episode schizophrenia and the relationship between such patterns and clinical parameters.
  
  
  METHODS
  A cross-sectional diffusion tensor imaging study of 113 medication-naive patients with first-episode schizophrenia and 110 demographically matched healthy control individuals. The study was conducted in the mental health center of West China Hospital, Sichuan University, Chengdu, China, from January 2006 to June 2014.
  
  
  METHODS
  The patterns of white matter abnormalities revealed by tract-specific analysis in conjunction with hierarchical clustering.
  
  
  RESULTS
  With diffusion features extracted from 18 fiber tracts, cluster analysis revealed 2 patterns of abnormalities. One pattern (42.5% of patient sample) showed widespread white matter abnormalities compared with matched healthy control individuals, while another pattern (57.5% of patient sample) only showed circumscribed regional white matter abnormalities, mainly in the left superior longitudinal fasciculus. Patients in these subgroups did not differ in demographic features; however, negative symptoms were more severe in patients with widespread white matter abnormalities.
  
  
  CONCLUSIONS
  Two distinct patterns of white matter abnormalities exist at the early phase of schizophrenia, with those having global abnormalities experiencing more severe negative symptoms. The finding that distinct subgroups of patients with schizophrenia have different forms of white matter pathology may reflect qualitatively distinct genetic influences or neurodevelopmental alterations and thus represents a promising strategy for resolving neurobiological heterogeneity in the schizophrenia syndrome.
authors.affiliation: Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
authors.forename: Huaiqiang
authors.initials: H
authors.lastname: Sun
authors.affiliation: Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
authors.forename: Su
authors.initials: S
authors.lastname: Lui
authors.affiliation: Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
authors.forename: Li
authors.initials: L
authors.lastname: Yao
authors.affiliation: Department of Psychiatry and Oncology, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Deng
authors.affiliation: Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Xiao
authors.affiliation: Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
authors.forename: Wenjing
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
authors.forename: Xiaoqi
authors.initials: X
authors.lastname: Huang
authors.affiliation: Department of Psychiatry and Oncology, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
authors.forename: Junmei
authors.initials: J
authors.lastname: Hu
authors.affiliation: Department of Oncology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Bi
authors.affiliation: Department of Psychiatry and Oncology, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Li
authors.affiliation: Department of Psychiatry, University of Texas Southwestern, Dallas.
authors.forename: John A
authors.initials: JA
authors.lastname: Sweeney
authors.affiliation: Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China2Department of Psychiatry and Oncology, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Si.
authors.forename: Qiyong
authors.initials: Q
authors.lastname: Gong
mesh_terms: D000293:Adolescent; D000328:Adult; D001921:Brain / Q000473:pathology*; D016022:Case-Control Studies; D016000:Cluster Analysis; D015331:Cohort Studies; D038524:Diffusion Magnetic Resonance Imaging; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009434:Neural Pathways / Q000473:pathology; D012559:Schizophrenia / Q000175:diagnosis* / Q000473:pathology; D066127:White Matter / Q000473:pathology*; D055815:Young Adult