J Psychiatry Neurosci 2015;40(2):100-107
William Pettersson-Yeo, PhD; Stefania Benetti, PhD; Silvia Frisciata, BSc; Marco Catani, PhD; Steve C.R. Williams, PhD; Paul Allen, PhD; Philip McGuire, PhD; Andrea Mechelli, PhD
Background: Neuroimaging studies of ultra-high risk (UHR) and first-episode psychosis (FEP) have revealed widespread alterations in brain structure and function. Recent evidence suggests there is an intrinsic relationship between these 2 types of alterations; however, there is very little research linking these 2 modalities in the early stages of psychosis.
Methods: To test the hypothesis that functional alteration in UHR and FEP participants would be associated with corresponding structural alteration, we examined brain function and structure in these participants as well as in a group of healthy controls using multimodal MRI. The data were analyzed using statistical parametric mapping.
Results: We included 24 participants in the FEP group, 18 in the UHR group and 21 in the control group. Patients in the FEP group showed a reduction in functional activation in the left superior temporal gyrus relative to controls, and the UHR group showed intermediate values. The same region showed a corresponding reduction in grey matter volume in the FEP group relative to controls. However, while the difference in grey matter volume remained significant after including functional activation as a covariate of no interest, the reduction in functional activation was no longer evident after including grey matter volume as a covariate of no interest.
Limitations: Our sample size was relatively small. All participants in the FEP group and 2 in the UHR group had received antipsychotic medication, which may have impacted neurofunction and/or neuroanatomy.
Conclusion: Our results suggest that superior temporal dysfunction in early psychosis is accounted for by a corresponding alteration in grey matter volume. This finding has important implications for the interpretation of functional alteration in early psychosis.
Submitted Mar. 19, 2014; Revised June 1, 2014; Accepted June 5, 2014; Early-released Oct. 21, 2014.
Acknowledgments: This work was supported by the Wellcome Trust [WT085390/Z/08/Z]. W. Pettersson-Yeo was supported by a PhD studentship from the Medical Research Council. The authors thank the NIHR Biomedical Research Centre for Mental Health at the South London and Maudsley NHS Foundation Trust for its continued support of our translational research objectives.
Affiliations: From the Departments of Psychosis Studies (Pettersson- Yeo, Benetti, Frisciata, Allen, McGuire, Mechelli), Forensic and Neurodevelopmental Science (Catani), and Neuroimaging, Centre for Neuroimaging Sciences (Williams), Institute of Psychiatry, King’s College London, De Crespigny Park, London, UK; and the CIMeC-Center for Mind/Brain Studies, University of Trento, Trento, Italy (Benetti).
Competing interests: None declared.
Contributors: M. Catani, S.C.R. Williams, P. Allen, P. McGuire and A. Mechelli designed the study. W. Pettersson-Yeo and S. Benetti acquired the data, which W. Pettersson-Yeo, S. Benetti, S. Frisciata and A. Mechelli analyzed. W. Pettersson-Yeo wrote the article, which all authors reviewed and approved for publication.
Correspondence to: W. Pettersson-Yeo, Department of Psychosis Studies, PO Box 67, Institute of Psychiatry, King’s College London, De Crespigny Park, London UK SE5 8AF; firstname.lastname@example.org