Symptom Remission and Brain Cortical Networks at First Clinical Presentation of Psychosis: The OPTiMiSE Study
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Symptom Remission and Brain Cortical Networks at First Clinical Presentation of Psychosis : The OPTiMiSE Study. / OPTiMiSE study group.
In: Schizophrenia Bulletin, Vol. 47, No. 2, 2021, p. 444-455.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Symptom Remission and Brain Cortical Networks at First Clinical Presentation of Psychosis
T2 - The OPTiMiSE Study
AU - Dazzan, Paola
AU - Lawrence, Andrew J.
AU - Reinders, Antje A.T.S.
AU - Egerton, Alice
AU - van Haren, Neeltje E.M.
AU - Merritt, Kate
AU - Barker, Gareth J.
AU - Perez-Iglesias, Rocio
AU - Sendt, Kyra Verena
AU - Demjaha, Arsime
AU - Nam, Kie W.
AU - Sommer, Iris E.
AU - Pantelis, Christos
AU - Wolfgang Fleischhacker, W.
AU - van Rossum, Inge Winter
AU - Galderisi, Silvana
AU - Mucci, Armida
AU - Drake, Richard
AU - Lewis, Shon
AU - Weiser, Mark
AU - Martinez Diaz-Caneja, Covadonga M.
AU - Janssen, Joost
AU - Diaz-Marsa, Marina
AU - Rodríguez-Jimenez, Roberto
AU - Arango, Celso
AU - Baandrup, Lone
AU - Broberg, Brian
AU - Rostrup, Egill
AU - Ebdrup, Bjørn H.
AU - Glenthøj, Birte
AU - Kahn, Rene S.
AU - McGuire, Philip
AU - OPTiMiSE study group
PY - 2021
Y1 - 2021
N2 - Individuals with psychoses have brain alterations, particularly in frontal and temporal cortices, that may be particularly prominent, already at illness onset, in those more likely to have poorer symptom remission following treatment with the first antipsychotic. The identification of strong neuroanatomical markers of symptom remission could thus facilitate stratification and individualized treatment of patients with schizophrenia. We used magnetic resonance imaging at baseline to examine brain regional and network correlates of subsequent symptomatic remission in 167 medication-naïve or minimally treated patients with first-episode schizophrenia, schizophreniform disorder, or schizoaffective disorder entering a three-phase trial, at seven sites. Patients in remission at the end of each phase were randomized to treatment as usual, with or without an adjunctive psycho-social intervention for medication adherence. The final follow-up visit was at 74 weeks. A total of 108 patients (70%) were in remission at Week 4, 85 (55%) at Week 22, and 97 (63%) at Week 74. We found no baseline regional differences in volumes, cortical thickness, surface area, or local gyrification between patients who did or did not achieved remission at any time point. However, patients not in remission at Week 74, at baseline showed reduced structural connectivity across frontal, anterior cingulate, and insular cortices. A similar pattern was evident in patients not in remission at Week 4 and Week 22, although not significantly. Lack of symptom remission in first-episode psychosis is not associated with regional brain alterations at illness onset. Instead, when the illness becomes a stable entity, its association with the altered organization of cortical gyrification becomes more defined.
AB - Individuals with psychoses have brain alterations, particularly in frontal and temporal cortices, that may be particularly prominent, already at illness onset, in those more likely to have poorer symptom remission following treatment with the first antipsychotic. The identification of strong neuroanatomical markers of symptom remission could thus facilitate stratification and individualized treatment of patients with schizophrenia. We used magnetic resonance imaging at baseline to examine brain regional and network correlates of subsequent symptomatic remission in 167 medication-naïve or minimally treated patients with first-episode schizophrenia, schizophreniform disorder, or schizoaffective disorder entering a three-phase trial, at seven sites. Patients in remission at the end of each phase were randomized to treatment as usual, with or without an adjunctive psycho-social intervention for medication adherence. The final follow-up visit was at 74 weeks. A total of 108 patients (70%) were in remission at Week 4, 85 (55%) at Week 22, and 97 (63%) at Week 74. We found no baseline regional differences in volumes, cortical thickness, surface area, or local gyrification between patients who did or did not achieved remission at any time point. However, patients not in remission at Week 74, at baseline showed reduced structural connectivity across frontal, anterior cingulate, and insular cortices. A similar pattern was evident in patients not in remission at Week 4 and Week 22, although not significantly. Lack of symptom remission in first-episode psychosis is not associated with regional brain alterations at illness onset. Instead, when the illness becomes a stable entity, its association with the altered organization of cortical gyrification becomes more defined.
KW - cortical thickness
KW - first episode
KW - gyrification
KW - MRI
KW - OPTiMiSE
KW - schizophrenia
KW - trial
U2 - 10.1093/schbul/sbaa115
DO - 10.1093/schbul/sbaa115
M3 - Journal article
C2 - 33057670
AN - SCOPUS:85103226491
VL - 47
SP - 444
EP - 455
JO - Schizophrenia Bulletin
JF - Schizophrenia Bulletin
SN - 0586-7614
IS - 2
ER -
ID: 259622172