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Increased diffusivity in gray matter in recent onset schizophrenia is associated with clinical symptoms and social
Jung Sun Lee1, Chang-Yoon Kim2, Yeon Ho Joo2
1Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Introduction:
Diffusion weighted MRI (dMRI) is a method sensitive to pathological changes affecting tissue microstructure. Most dMRI studies in schizophrenia, however, have focused solely on white matter. There is a possibility, however, that subtle changes in diffusivity exist in gray matter (GM). Accordingly, we investigated diffusivity in GM in patients with recent onset schizophrenia.
Methods:
We enrolled 45 patients and 21 age and sex-matched healthy controls. All subjects were evaluated using the short form of the Wechsler Adult Intelligence Scale, the Positive and Negative Syndrome Scale (PANSS), and the video based social cognition scale. DMRI and T1W images were acquired on a 3 Tesla magnet, and mean Fractional Anisotropy (FA), Trace (TR) and volume were calculated for each of the 68 cortical GM Regions of Interest parcellated using FreeSurfer.
Results:
There was no significant difference of FA and GM volume between groups after Bonferroni correction. For the dMRI measures, however, patients evinced increased TR in the left bank of the superior temporal sulcus, the right inferior parietal, the right inferior temporal, and the right middle temporal gyri. In addition, higher TR in the right middle temporal gyrus and the right inferior temporal gyrus, respectively, was associated with decreased social function and higher PANSS score in patients with schizophrenia.
Conclusion:
This study demonstrates high sensitivity of dMRI to subtle pathology in GM in recent onset schizophrenia, as well as an association between increased diffusivity in temporal GM regions and abnormalities in social cognition and exacerbation of psychiatric symptoms.
Insights
Diffusion weighted MRI (dMRI) reveals subtle gray matter (GM) changes in recent onset schizophrenia. Increased diffusivity in temporal GM areas correlates with impaired social function and symptom severity.
Area of Science:
- Neuroimaging
- Psychiatry
- Medical Physics
Background:
- Diffusion weighted MRI (dMRI) typically focuses on white matter in schizophrenia research.
- Subtle microstructural changes in gray matter (GM) may be present in schizophrenia.
Purpose of the Study:
- To investigate gray matter (GM) diffusivity using dMRI in patients with recent onset schizophrenia.
- To explore the relationship between GM diffusivity and clinical/social function.
Main Methods:
- 45 patients with recent onset schizophrenia and 21 healthy controls underwent dMRI and T1W imaging.
- Mean Fractional Anisotropy (FA), Trace (TR), and volume were calculated for 68 cortical GM regions.
- Cognitive and social function, and psychiatric symptoms were assessed.
Main Results:
- No significant differences in FA or GM volume between groups.
- Patients showed increased TR in specific temporal and parietal GM regions.
- Increased TR in temporal GM correlated with poorer social function and higher symptom scores.
Conclusions:
- dMRI is sensitive to subtle gray matter pathology in early schizophrenia.
- Increased temporal GM diffusivity is associated with social cognition deficits and symptom exacerbation.
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