TY - JOUR
T1 - Two patterns of white matter abnormalities in medication-naive patients with first-episode schizophrenia revealed by diffusion tensor imaging and cluster analysis
AU - Sun, Huaiqiang
AU - Lui, Su
AU - Yao, Li
AU - Deng, Wei
AU - Xiao, Yuan
AU - Zhang, Wenjing
AU - Huang, Xiaoqi
AU - Hu, Junmei
AU - Bi, Feng
AU - Li, Tao
AU - Sweeney, John A.
AU - Gong, Qiyong
N1 - Publisher Copyright:
Copyright 2015 American Medical Association. All rights reserved.
PY - 2015/7/1
Y1 - 2015/7/1
N2 - IMPORTANCE 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. DESIGN, SETTING, AND PARTICIPANTS 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. MAIN OUTCOMES AND MEASURES 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 AND RELEVANCE Two distinct patterns of white matter abnormalities exist at the early phase of schizophrenia, with those having global abnormalities experiencing more severe negative symptoms.
AB - IMPORTANCE 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. DESIGN, SETTING, AND PARTICIPANTS 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. MAIN OUTCOMES AND MEASURES 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 AND RELEVANCE Two distinct patterns of white matter abnormalities exist at the early phase of schizophrenia, with those having global abnormalities experiencing more severe negative symptoms.
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U2 - 10.1001/jamapsychiatry.2015.0505
DO - 10.1001/jamapsychiatry.2015.0505
M3 - Article
C2 - 25993492
AN - SCOPUS:84937484628
SN - 2168-622X
VL - 72
SP - 678
EP - 686
JO - JAMA Psychiatry
JF - JAMA Psychiatry
IS - 7
ER -