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Altered Cellular White Matter But Not Extracellular Free Water on Diffusion MRI in Individuals at Clinical High Risk
Yingying Tang1, Ofer Pasternak1, Marek Kubicki1
1Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China (Tang, Zhang, Junjie Wang, Xu, Qian, Jijun Wang); the Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston (Tang, Pasternak, Kubicki, Rathi, Zhang, Zhu, Shenton); the Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston (Pasternak, Kubicki, Rathi, Shenton); the Institute of Mental Health, Suzhou Psychiatric Hospital, Affiliated Guangji Hospital of Soochow University, Suzhou, Jiangsu, China (Junjie Wang); the Department of Psychology, Florida A&M University, Tallahassee (Li); the Massachusetts Mental Health Center, Public Psychiatry Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston (Woodberry, Keshavan, Stone, Seidman); the McGovern Institute for Brain Research and the Poitras Center for Affective Disorders Research, Massachusetts Institute of Technology, Cambridge (Whitfield-Gabrieli); the Department of Psychiatry (Niznikiewicz, McCarley) and Research and Development (Shenton), Veterans Affairs Boston Healthcare System, Brockton Division, Brockton, Mass.; the Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China (Jijun Wang); the CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Science, China (Jijun Wang); the Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston (Seidman).
Early brain cellular changes, not extracellular ones, were found in individuals at clinical high risk for psychosis. These cellular alterations correlate with declining daily functioning, suggesting a potential predisposition before psychosis onset.
Area of Science:
- Neuroimaging
- Psychiatry
- Neuroscience
Background:
- Detecting brain abnormalities in clinical high-risk populations before psychosis onset is crucial for understanding disease pathways and developing interventions.
- Previous studies implicated white matter alterations after a first psychotic episode.
- This study investigates early cellular and extracellular changes in medication-naive individuals at clinical high risk for psychosis.
Purpose of the Study:
- To determine if cellular and extracellular white matter alterations are present in individuals at clinical high risk for psychosis.
- To explore the relationship between these alterations and functional decline.
Main Methods:
- Compared 50 individuals at clinical high risk (40 never medicated) with 50 healthy controls.
- Utilized 3-T multishell diffusion MRI to assess white matter measures.
- Estimated fractional anisotropy of cellular tissue (FAT) and extracellular free water volume fraction (FW).
Main Results:
- Found significantly lower FAT in the clinical high-risk group compared to controls.
- Observed no significant differences in FW between the groups.
- Lower FAT was associated with a decline in Global Assessment of Functioning Scale (GAF) score.
Conclusions:
- Cellular alterations, specifically lower FAT, characterize the clinical high-risk group, particularly those with functional decline.
- These findings suggest an early cellular deficit predating psychosis onset.
- Absence of extracellular alterations indicates they may be associated with acute psychosis rather than early risk stages.
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