Brain structure abnormalities in first-episode psychosis patients with persistent apathy

Area of Science:

• Neuroscience
• Psychiatry
• Neuroimaging

Background:

• Apathy is a common, debilitating symptom in first-episode psychosis (FEP) associated with poor outcomes.
• The underlying neurobiology of apathy in FEP remains poorly understood.
• Early identification of biological markers for apathy is crucial for targeted interventions.

Purpose of the Study:

• To investigate differences in brain structure between FEP patients with persistent apathy (PA) and those without (NPA).
• To identify early neuroanatomical correlates of persistent apathy in the initial stages of psychosis.

Main Methods:

• Seventy Norwegian FEP patients were assessed for persistent apathy using the Apathy Evaluation Scale over one year.
• Magnetic Resonance Imaging (MRI) was used to measure cortical thickness and subcortical volumes.
• Structural brain measures were compared between PA (N=18) and NPA (N=52) groups.

Main Results:

• Patients with persistent apathy exhibited significantly thinner left orbitofrontal cortex compared to those without apathy.
• A significant reduction in cortical thickness was also observed in the left anterior cingulate cortex in the PA group.
• These findings remained significant after adjusting for depressive symptoms and antipsychotic medication use.

Conclusions:

• Persistent apathy in early-phase FEP is associated with distinct structural brain alterations.
• These changes are localized to brain regions critical for motivation and reward processing.
• The observed early structural differences suggest a specific neurobiological profile for persistent apathy in FEP.