Effect Factors Of Grey Matter And White Matter Abnormality In First-episode Drug Na?ve Schizophrenia

Objectives:To investigate the difference of cortical thickness,gray matter volume and white matter integrity between first-episode drug-na?ve schizophrenia patients and healthy controls.Methods:At baseline,Structured Clinical Interview for DSM-IV Patient Edition,Brief Psychiatric Rating Scale(BPRS)and Scale for Assessment of Negative Symptomswere(SANS)were used in patient groups.While Structured Clinical Interview for DSM-IV Non-Patient Edition were used in patient groups.Both groups were tested cognitive function using MATRICS Consensus Cognitive Battery(MCCB).Magnetization prepared rapid gradient echo imaging(MPRAGE)were used in both groups to acquaire the three-dimension Magnetic Resonance Imaging(MRI)images.Freesurfer softeare was used to analysis the morphological difference between two groups.Echo Planar Imaging(EPI)was used to acquaire the Diffusion Tensor Imaging(DTI)images.Tensor-Based Spatial Statistics(TBSS)were used to analysis the white matter integrity difference between two groups at baseline.After complete the baseline assessment,patients group were treated with second-generation antipsychotics for at least 8 weeks.While control group were not apllied any intervation for 8 weeks.Patients were reassessed using BPRS and SANS and all participants were resaaessed cognitive function with MCCB after 8 weeks.All participants underwent a second MRI scan using MPRAGE and EPI sequence to acquire their structure and DTI image data.Longitudinal data analysis method were used to analyze the change of grey matter and whitter matter integrity between this 8-week period.Results:At baseline,seventy patients and 70 controls were recuited,but only 55 patients and 61 controls were analized after quality control.There are significant differences between patients and healthy controls in the 7 cognitive domains of MCCB.The cortical thickness of patients were significantly thinner than healthy controls mainly in left lingual gyrus,left island gyrus,left fusiform gyrus,right island gyrus,right inferior parietal lobule and right lateral occupital.There were significant correlation between the cortical thickness of left island gyrus,left fusiform gyrus showed and BPRS positive scores(r =-0.324,r =-0.269,P < 0.05).The patients showed lower FA values in forceps,left superior longitudinal fasciculus,inferior fronto-occipital fasciculus,left corticospinal tract,left uncinate fasciculus,left anterior thalamic radiation,and bilateral inferior longitudinal fasciculi.There were significant negative correlation between the mean FA values in forceps major,left thalamus radiation,left superior longitudinal fasciculus and SANS scores(r =-0.412,P = 0.002).There were significant positive correlation between the mean FA values in left superior longitudinal fasciculus and working memory domain scores(r = 0.377,P = 0.005),visual learning domain scores(r = 0.281,P = 0.038)After 8 weeks,29 patients and 35 healthy controls completed the follow-up reassessment,while 25 patients and 31 healthy controls were analized after quality control.There were no significant difference between two groups in 7 MCCB domain scores(P > 0.05).The patients showed more cortical thickness lost than healthy controls in bilateral superior frontal gyri and left temporal gyrus.There were no brain area where the patient showed less cortical thickness lost than healthy controls.There were no significant change of DTI measures after 8 weeks in those regions which differentiate two groups at baseline.Conclusions:There were already gray matter and white matter deficis in the early stage of first-episode drug na?ve schizophrenia,which including thinning of cortical thickness,lost of gray matter volume and white matter integrity impairments.The cortical thickness of first-episode drug na?ve schizophrenia patients are more correlated with positive clinical feature.The progressive lost of cortical thickness after 8-week antipsychotic treatment were due to disease duration and medication,but mainly due to medication.White matter deficits in medication naive schizophrenia patients were associated with negative symptoms and cognitive impairment.The 8-week antipsychotics medication didn’t change either the abnormal white matter interigity of patientsor or the negative sympotms.