Brain structure linked to neuropsychopathology in psychosis patients

By Mark Cowen, Senior medwireNews Reporter

Results from an Italian study show that the structural development of key brain regions is associated with neuropsychopathology in patients with first-episode schizophrenia (FES).

Silvia Rigucci (Sapienza University of Rome) and team found significant associations between gray matter (GM) volume and white matter (WM) fractional anisotropy (FA) values in a number of brain regions and Positive and Negative Syndrome Scale (PANSS) scores in FES patients.

The findings, published in Acta Psychiatrica Scandinavica, are consistent with schizophrenia being a "neurodevelopmentally derived 'misconnection syndrome' involving connections between cortical regions and the cerebellum mediated through the thalamus," say the researchers.

The team studied 19 FES patients, aged between 18 and 30 years, and 18 age-, gender-, handedness-, and education-matched controls who underwent magnetic resonance imaging of the brain.

Patients with FES were also assessed for symptoms using the PANSS and underwent extensive neuropsychologic tests of processing speed, sustained attention/vigilance, working memory, verbal memory, visual memory, reasoning and problem solving, and social cognition.

The team found that, compared with controls, FES patients showed significantly decreased GM volume in the superior, middle, inferior, and fusiform gyrus of the left temporal lobe, and a trend toward decreased GM volume in the right cerebellum and right cuneus.

FES patients also showed significantly reduced WM FA values in all major WM tracts compared with controls.

Among FES patients, PANSS disorganized factor scores were inversely related to left cerebellar GM volume and WM FA values in the left cerebellum, the inferior fronto-occipital fasciculi (IFOF), and the inferior longitudinal fasciculi.

Furthermore, PANSS negative factor scores were inversely related to WM FA values in the IFOF and the superior longitudinal fasciculi.

In addition, poorer scores in tests of facial emotion recognition (social cognition) were associated with decreased temporo-occipital GM volume and WM disarray in the superior and middle temporal gyri, the anterior thalamic radiation, and the superior longitudinal fasciculi. Poorer processing speed and visual memory were also associated with a similar pattern of WM disarray.

Rigucci et al conclude: "Consistent with a neurodevelopmentally derived 'misconnection syndrome', our results suggest how the structural development of key brain regions may relate to neuropsychopathological dysfunction even at the very early stages of schizophrenia."

However, they add that further longitudinal studies are needed to confirm their findings.

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