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Motor abnormalities and basal ganglia in first-episode psychosis (FEP)

Published online by Cambridge University Press:  02 March 2020

Manuel J. Cuesta Open the ORCID record for Manuel J. Cuesta [Opens in a new window] ,
Pablo Lecumberri ,
Lucia Moreno-Izco ,
Jose M. López-Ilundain ,
María Ribeiro ,
Teresa Cabada ,
Ruth Lorente-Omeñaca ,
Gabriel de Erausquin ,
Gracian García-Martí  and
Julio Sanjuan
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Manuel J. Cuesta*
Affiliation:
Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
Pablo Lecumberri
Affiliation:
IdiSNA, Navarra Institute for Health Research, Pamplona, Spain Movalsys S. L., NavarraBiomed, Pamplona, Spain
Lucia Moreno-Izco
Affiliation:
Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
Jose M. López-Ilundain
Affiliation:
Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
María Ribeiro
Affiliation:
Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
Teresa Cabada
Affiliation:
IdiSNA, Navarra Institute for Health Research, Pamplona, Spain Department of Neuroradiology, Complejo Hospitalario de Navarra, Pamplona, Spain
Ruth Lorente-Omeñaca
Affiliation:
Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
Gabriel de Erausquin
Affiliation:
Zachry Foundation, The Glenn Biggs Institute of Alzheimer's & Neurodegenerative Disorders, UT Heath San Antonio, Texas, USA
Gracian García-Martí
Affiliation:
Radiology Department, CIBERSAM, Valencia, España, Quirón Salud Hospital, Valencia, España
Julio Sanjuan
Affiliation:
Research Institute of Clinic University Hospital of Valencia (INCLIVA), Valencia, Spain CIBERSAM, Biomedical Research Network on Mental Health Area, Madrid, Spain Department of Psychiatric, University of Valencia School of Medicine, Valencia, Spain
Ana M. Sánchez-Torres
Affiliation:
Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
Marisol Gómez
Affiliation:
IdiSNA, Navarra Institute for Health Research, Pamplona, Spain Movalsys S. L., NavarraBiomed, Pamplona, Spain Department of Statistics, Computer Science and Mathematics, Universidad Pública de Navarra (UPNA), Pamplona, Spain
Victor Peralta
Affiliation:
IdiSNA, Navarra Institute for Health Research, Pamplona, Spain Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
*
Author for correspondence: Manuel J. Cuesta, E-mail: mcuestaz@cfnavarra.es
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Abstract

Background

Motor abnormalities (MAs) are the primary manifestations of schizophrenia. However, the extent to which MAs are related to alterations of subcortical structures remains understudied.

Methods

We aimed to investigate the associations of MAs and basal ganglia abnormalities in first-episode psychosis (FEP) and healthy controls. Magnetic resonance imaging was performed on 48 right-handed FEP and 23 age-, gender-, handedness-, and educational attainment-matched controls, to obtain basal ganglia shape analysis, diffusion tensor imaging techniques (fractional anisotropy and mean diffusivity), and relaxometry (R2*) to estimate iron load. A comprehensive motor battery was applied including the assessment of parkinsonism, catatonic signs, and neurological soft signs (NSS). A fully automated model-based segmentation algorithm on 1.5T MRI anatomical images and accurate corregistration of diffusion and T2* volumes and R2* was used.

Results

FEP patients showed significant local atrophic changes in left globus pallidus nucleus regarding controls. Hypertrophic changes in left-side caudate were associated with higher scores in sensory integration, and in right accumbens with tremor subscale. FEP patients showed lower fractional anisotropy measures than controls but no significant differences regarding mean diffusivity and iron load of basal ganglia. However, iron load in left basal ganglia and right accumbens correlated significantly with higher extrapyramidal and motor coordination signs in FEP patients.

Conclusions

Taken together, iron load in left basal ganglia may have a role in the emergence of extrapyramidal signs and NSS of FEP patients and in consequence in the pathophysiology of psychosis.

Keywords

Abnormal movementsakathisiacatatoniaextrapyramidal signsfirst-degree relativesfirst-episode psychosishealthy controlsmean diffusivityneurological assessmentneurological soft signsnuclear magnetic resonanceparkinsonismR2*relaxometryschizophreniashape analysisunaffected siblingsvoxel analysis
Type
Original Article
Information
Psychological Medicine , Volume 51 , Issue 10 , July 2021 , pp. 1625 - 1636
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Copyright
Copyright © The Author(s) 2020. Published by Cambridge University Press

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