Anatomical substrates of cognitive and clinical dimensions in first episode schizophrenia

ObjectiveTo explore gray (GM) and white matter (WM) abnormalities and the relationships with neuropsychopathology in first-episode schizophrenia (FES). MethodNineteen patients with first episode of non-affective psychosis and 18 controls underwent a magnetic resonance voxel-based morphometry. Additionally, WM fractional anisotropy (FA) was calculated. For correlative analysis, symptoms and neuropsychological performances were scored by PANSS and by a comprehensive neuropsychological assessment respectively. ResultsPatients showed significantly decreased volume of left temporal lobe and disarray of all major WM tracts. Disorganized PANSS factor was inversely related to left cerebellar GM volume (corrected P=0.03) and to WM FA of the left cerebellum, inferior fronto-occipital fasciculi (IFOF), and inferior longitudinal fasciculi (corrected P<0.05). PANSS negative factor was inversely related to FA in the IFOF and superior longitudinal fasciculi (corrected P<0.05). Impairment in facial emotion identification showed associations with temporo-occipital GM volume decrease (corrected P=0.003) and WM disarray of superior and middle temporal gyri, anterior thalamic radiation, and superior longitudinal fasciculi (corrected P<0.05). Speed of processing and visual memory correlated with WM abnormalities in fronto-temporal tracts. ConclusionThese results confirm how the structural development of key brain regions is related to neuropsychopathological dysfunction in FES, consistently with a neurodevelopmentally derived misconnection syndrome.