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White-matter microstructure in previously drug-naive patients with schizophrenia after 6 weeks of treatment

Published online by Cambridge University Press:  27 February 2013

Q. Wang ,
C. Cheung ,
W. Deng ,
M. Li ,
C. Huang ,
X. Ma ,
Y. Wang ,
L. Jiang ,
P. C. Sham  and
D. A. Collier
...Show all authors
Q. Wang
Affiliation:
Mental Health Centre and Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, China State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
C. Cheung
Affiliation:
Department of Psychiatry, University of Hong Kong, Pokfulam, SAR China
W. Deng
Affiliation:
Mental Health Centre and Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, China State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
M. Li
Affiliation:
Mental Health Centre and Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, China
C. Huang
Affiliation:
Mental Health Centre and Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, China
X. Ma
Affiliation:
Mental Health Centre and Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, China State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
Y. Wang
Affiliation:
Mental Health Centre and Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, China State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
L. Jiang
Affiliation:
Mental Health Centre and Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, China
P. C. Sham
Affiliation:
Department of Psychiatry, University of Hong Kong, Pokfulam, SAR China
D. A. Collier
Affiliation:
MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, UK
Q. Gong
Affiliation:
Huaxi MR Research Centre, Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
S. E. Chua
Affiliation:
Department of Psychiatry, University of Hong Kong, Pokfulam, SAR China
G. M. McAlonan*
Affiliation:
Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King's College London, UK
T. Li*
Affiliation:
Mental Health Centre and Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, China State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
*
*Author for correspondence: Professor T. Li, Mental Health Centre and Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China. (Email: xuntao26@hotmail.com) [T. Li] (Email: grainne.mcalonan@kcl.ac.uk) [G. McAlonan]
*Author for correspondence: Professor T. Li, Mental Health Centre and Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China. (Email: xuntao26@hotmail.com) [T. Li] (Email: grainne.mcalonan@kcl.ac.uk) [G. McAlonan]
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Abstract

Background

It is not clear whether the progressive changes in brain microstructural deficits documented in previous longitudinal magnetic resonance imaging (MRI) studies might be due to the disease process or to other factors such as medication. It is important to explore the longitudinal alterations in white-matter (WM) microstructure in antipsychotic-naive patients with first-episode schizophrenia during the very early phase of treatment when relatively ‘free’ from chronicity.

Method

Thirty-five patients with first-episode schizophrenia and 22 healthy volunteers were recruited. High-resolution diffusion tensor imaging (DTI) was obtained from participants at baseline and after 6 weeks of treatment. A ‘difference map’ for each individual was calculated from the 6-week follow-up fractional anisotropy (FA) of DTI minus the baseline FA. Differences in Positive and Negative Syndrome Scale (PANSS) scores and Global Assessment of Functioning (GAF) scores between baseline and 6 weeks were also evaluated and expressed as a 6-week/baseline ratio.

Results

Compared to healthy controls, there was a significant decrease in absolute FA of WM around the bilateral anterior cingulate gyrus and the right anterior corona radiata of the frontal lobe in first-episode drug-naive patients with schizophrenia following 6 weeks of treatment. Clinical symptoms improved during this period but the change in FA did not correlate with the changes in clinical symptoms or the dose of antipsychotic medication.

Conclusions

During the early phase of treatment, there is an acute reduction in WM FA that may be due to the effects of antipsychotic medications. However, it is not possible to entirely exclude the effects of underlying progression of illness.

Keywords

First episodelongitudinal studymicrostructural deficitsschizophrenia
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 11 , November 2013 , pp. 2301 - 2309
Copyright
Copyright © Cambridge University Press 2013 

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