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Intersection of verbal memory and expressivity on cortical contrast and thickness in first episode psychosis

Published online by Cambridge University Press:  28 August 2019

Carolina Makowski
McGill Centre for Integrative Neuroscience, McGill University, Montreal, Canada McConnell Brain Imaging Centre, Montreal Neurological Institute, Montreal, Canada Ludmer Centre for Neuroinformatics and Mental Health, Montreal, Canada Department of Psychiatry, McGill University, Verdun, Canada
John D. Lewis
McGill Centre for Integrative Neuroscience, McGill University, Montreal, Canada McConnell Brain Imaging Centre, Montreal Neurological Institute, Montreal, Canada Ludmer Centre for Neuroinformatics and Mental Health, Montreal, Canada
Claude Lepage*
McGill Centre for Integrative Neuroscience, McGill University, Montreal, Canada McConnell Brain Imaging Centre, Montreal Neurological Institute, Montreal, Canada Ludmer Centre for Neuroinformatics and Mental Health, Montreal, Canada
Ashok K. Malla
Department of Psychiatry, McGill University, Verdun, Canada Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, Verdun, Canada
Ridha Joober
Department of Psychiatry, McGill University, Verdun, Canada Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, Verdun, Canada
Alan C. Evans
McGill Centre for Integrative Neuroscience, McGill University, Montreal, Canada McConnell Brain Imaging Centre, Montreal Neurological Institute, Montreal, Canada Ludmer Centre for Neuroinformatics and Mental Health, Montreal, Canada
Martin Lepage*
Department of Psychiatry, McGill University, Verdun, Canada Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, Verdun, Canada
Author for correspondence: Martin Lepage, Email:
Author for correspondence: Martin Lepage, Email:



Longitudinal studies of first episode of psychosis (FEP) patients are critical to understanding the dynamic clinical factors influencing functional outcomes; negative symptoms and verbal memory (VM) deficits are two such factors that remain a therapeutic challenge. This study uses white-gray matter contrast at the inner edge of the cortex, in addition to cortical thickness, to probe changes in microstructure and their relation with negative symptoms and possible intersections with verbal memory.


T1-weighted images and clinical data were collected longitudinally for patients (N = 88) over a two-year period. Cognitive data were also collected at baseline. Relationships between baseline VM (immediate/delayed recall) and rate of change in two negative symptom dimensions, amotivation and expressivity, were assessed at the behavioral level, as well as at the level of brain structure.


VM, particularly immediate recall, was significantly and positively associated with a steeper rate of expressivity symptom decline (r = 0.32, q = 0.012). Significant interaction effects between baseline delayed recall and change in expressivity were uncovered in somatomotor regions bilaterally for both white-gray matter contrast and cortical thickness. Furthermore, interaction effects between immediate recall and change in expressivity on cortical thickness rates were uncovered across higher-order regions of the language processing network.


This study shows common neural correlates of language-related brain areas underlying expressivity and VM in FEP, suggesting deficits in these domains may be more linked to speech production rather than general cognitive capacity. Together, white-gray matter contrast and cortical thickness may optimally inform clinical investigations aiming to capture peri-cortical microstructural changes.

Original Articles
Copyright © Cambridge University Press 2019

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Authors share senior authorship.


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Intersection of verbal memory and expressivity on cortical contrast and thickness in first episode psychosis
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Intersection of verbal memory and expressivity on cortical contrast and thickness in first episode psychosis
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Intersection of verbal memory and expressivity on cortical contrast and thickness in first episode psychosis