J Psychiatry Neurosci 2012;37(4):305-12
Anne Ruef, MSc; Logos Curtis, MD, PhD; Guenael Moy, PhD; Severine Bessero, MSc; Maryse Badan Bâ, PhD; François Lazeyras, PhD; Karl-Olof Lövblad, MD; Sven Haller, MD,MSc; Alain Malafosse, MD, PhD; Panteleimon Giannakopoulos, MD; Marco Merlo, MD
Ruef — Faculty of Psychology and Educational Sciences, University of Geneva; Curtis, Moy, Bessero, Badan Bâ, Giannakipoulos, Merlo — Division of General Psychiatry, University Hospitals of Geneva; Lazeyras — Department of Radiology, University Hospitals of Geneva; Lövblad, Haller — Service neuro-diagnostique et neuro-interventionnel DISIM, University Hospitals of Geneva; Malafosse — Psychiatry Genetics Unit, University Hospitals of Geneva; Giannakopoulos — Division of Old Age Psychiatry, University Hospitals of Lausanne, Switzerland
Background: Several patterns of grey and white matter changes have been separately described in young adults with first-episode psychosis. Concomitant investigation of grey and white matter densities in patients with first-episode psychosis without other psychiatric comorbidities that include all relevant imaging markers could provide clues to the neurodevelopmental hypothesis in schizophrenia.
Methods: We recruited patients with first-episode psychosis diagnosed according to the DSM-IV-TR and matched controls. All participants underwent magnetic resonance imaging (MRI). Voxel-based morphometry (VBM) analysis and mean diffusivity voxel-based analysis (VBA) were used for grey matter data. Fractional anisotropy and axial, radial and mean diffusivity were analyzed using tract-based spatial statistics (TBSS) for white matter data.
Results: We included 15 patients and 16 controls. The mean diffusivity VBA showed significantly greater mean diffusivity in the first-episode psychosis than in the control group in the lingual gyrus bilaterally, the occipital fusiform gyrus bilaterally, the right lateral occipital gyrus and the right inferior temporal gyrus. Moreover, the TBSS analysis revealed a lower fractional anisotropy in the first-episode psychosis than in the control group in the genu of the corpus callosum, minor forceps, corticospinal tract, right superior longitudinal fasciculus, left middle cerebellar peduncle, left inferior longitudinal fasciculus and the posterior part of the fronto-occipital fasciculus. This analysis also revealed greater radial diffusivity in the first-episode psychosis than in the control group in the right corticospinal tract, right superior longitudinal fasciculus and left middle cerebellar peduncle. Limitations: The modest sample size and the absence of women in our series could limit the impact of our results.
Conclusion: Our results highlight the structural vulnerability of grey matter in posterior areas of the brain among young adult male patients with first-episode psychosis. Moreover, the concomitant greater radial diffusivity within several regions already revealed by the fractional anisotropy analysis supports the idea of a late myelination in patients with first-episode psychosis.
Submitted Aug. 15, 2011; Revised Nov. 27, 2011; Jan. 26, 2012; Accepted Jan. 30, 2012.
Acknowledgements: This work was performed in collaboration with the Centre of biomedical imagery (CIBM) in Geneva, Switzerland.
Competing interests: None declared.
Contributors: A. Ruef, L. Curtis, F. Lazeyras, K. Lövblad, A.Malafosse, P. Giannakopoulos and M. Merlo designed the study. A. Ruef, L. Curtis, S. Bessero, M. Badan Bâ, F. Lazeyras and K. Lövblad acquired the data, which A. Ruef, L. Curtis, G. Moy, S. Bessero, F. Lazeyras, S. Haller and P. Giannakopoulos analyzed. A. Ruef, L. Curtis, G. Moy, S. Bessero and P. Giannakopoulos wrote the article, which A. Ruef, L. Curtis, G. Moy, M. Badan Bâ, F. Lazeyras, K. Lövblad, S. Haller, A. Malafosse, P. Giannakipoulos and M. Merlo reviewed. All authors approved its publication.
Correspondence to: L. Curtis, Service de Psychiatrie Générale — Hôpitaux Universitaires de Genève, 2 Chemin du Petit-Bel-Air, 1225 Chêne-Bourg, Switzerland; Logos.Curtis@hcuge.ch