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Obstetric complications, cortical gyrification, and cognition in first-episode psychosis

Ana Costas-Carrera1,2, Norma Verdolini3, Gisela Mezquida4,5,6,7

  • 1Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain.

Psychological Medicine
|July 22, 2025
PubMed

Insights

Obstetric complications impact brain gyrification in males with first-episode psychosis (FEP). These complications affect working memory, with gyrification potentially mediating this relationship in healthy individuals, not FEP patients.

Area of Science:

  • Neuroscience
  • Psychiatry
  • Developmental Neuroscience

Background:

  • Obstetric complications (OCs) are linked to cognitive and brain abnormalities in schizophrenia.
  • Gyrification, a measure of cortical integrity, is altered in first-episode psychosis (FEP).

Purpose of the Study:

  • To investigate the relationship between OCs and gyrification in FEP.
  • To determine if gyrification mediates the link between OCs and cognitive function.

Main Methods:

  • Compared Local Gyrification Index (LGI) in FEP patients and healthy controls (HCs).
  • Used regression analyses for OCs and diagnosis interaction on LGI.
  • Conducted mediation analyses for LGI's effect on OCs and cognition.

Main Results:

  • FEP patients showed significant LGI differences in parietal, cingulate, and occipital cortices compared to HCs.
  • A significant interaction between OCs and diagnosis on left cingulate cortex (LCC) LGI was found in males, driven by gestational OCs.
  • OCs directly affected working memory in HCs, but not in FEP patients.

Conclusions:

  • OCs interact with diagnosis to predict LCC gyrification, with males with FEP and OCs exhibiting the lowest LGI.
  • OCs influence working memory, and LCC gyrification may mediate this in HCs, suggesting distinct neurodevelopmental pathways in psychosis.
Abstract

Keywords:
cognitioncortical foldingdeliveryepiphenomenafirst-episode psychosisgyrificationintrauterine periodmagnetic resonance imagingobstetric complicationsschizophreniaverbal memoryworking memory

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