Fibre density and fibre-bundle cross-section of the corticospinal tract are distinctly linked to psychosis-specific symptoms in antipsychotic-naïve patients with first-episode schizophrenia

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Multiple lines of research support the dysconnectivity hypothesis of schizophrenia. However, findings on white matter (WM) alterations in patients with schizophrenia are widespread and non-specific. Confounding factors from magnetic resonance image (MRI) processing, clinical diversity, antipsychotic exposure, and substance use may underlie some of the variability. By application of refined methodology and careful sampling, we rectified common confounders investigating WM and symptom correlates in a sample of strictly antipsychotic-naïve first-episode patients with schizophrenia. Eighty-six patients and 112 matched controls underwent diffusion MRI. Using fixel-based analysis (FBA), we extracted fibre-specific measures such as fibre density and fibre-bundle cross-section. Group differences on fixel-wise measures were examined with multivariate general linear modelling. Psychopathology was assessed with the Positive and Negative Syndrome Scale. We separately tested multivariate correlations between fixel-wise measures and predefined psychosis-specific versus anxio-depressive symptoms. Results were corrected for multiple comparisons. Patients displayed reduced fibre density in the body of corpus callosum and in the middle cerebellar peduncle. Fibre density and fibre-bundle cross-section of the corticospinal tract were positively correlated with suspiciousness/persecution, and negatively correlated with delusions. Fibre-bundle cross-section of isthmus of corpus callosum and hallucinatory behaviour were negatively correlated. Fibre density and fibre-bundle cross-section of genu and splenium of corpus callosum were negative correlated with anxio-depressive symptoms. FBA revealed fibre-specific properties of WM abnormalities in patients and differentiated associations between WM and psychosis-specific versus anxio-depressive symptoms. Our findings encourage an itemised approach to investigate the relationship between WM microstructure and clinical symptoms in patients with schizophrenia.
OriginalsprogEngelsk
TidsskriftEuropean Archives of Psychiatry and Clinical Neuroscience
Vol/bind273
Sider (fra-til)1797–1812
Antal sider16
ISSN0940-1334
DOI
StatusUdgivet - 2023

Bibliografisk note

Funding Information:
Open access funding provided by Royal Danish Library. Tina D. Kristensen is supported in part by a 2021 NARSAD Young Investigator Grant from the Brain and Behavior Research Foundation (ID 30112), as a designated Gregory & Tyler Starling Investigator. Further funding includes the Health Services in the Capital Region of Denmark, the Lundbeck Foundation Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS (R155-2013–16337), and Lundbeck Foundation grant for BHE (R316-2019–191).

Publisher Copyright:
© 2023, The Author(s).

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