Highlights The pathophysiology of salience network in schizophrenia remains poorly understood. We found reduced connectivity, but no Glx alterations in psychosis patients. The relationship between Glx and connectivity was abnormal in psychosis patients. Findings suggest altered glutamatergic neurometabolism and connectivity in psychosis.

Background-In the United States, the average duration of untreated psychosis (DUP) is 21 months and it remains unknown how longer DUP may affect brain functioning in antipsychoticnaïve patients with first episode psychosis (FEP). Our objective was to determine the effects of DUP on functional connectivity and brain morphology measured with resting state functional and structural MRI.Methods-Medication-naïve FEP patients were referred from various clinical settings. After accounting for exclusion criteria, attrition, and data quality, final analyses included 55 patients (35M/20F; mean age of 24.18 years). FEP patients were subjected to a 16-week trial of risperidone, a commonly used antipsychotic drug. Treatment response was calculated as change in the BPRS psychosis subscale between baseline and 16 weeks. Resting state functional connectivity MRI and brain morphology (surface area and cortical thickness) were assessed.

Introduction:The dorsal striatum, comprised of the caudate and putamen, is implicated in the pathophysiology of psychosis spectrum disorders. Given the high concentration of dopamine receptors in the striatum, striatal dopamine imbalance is a likely cause in cortico-striatal dysconnectivity. There is great interest in understanding the relationship between striatal abnormalities in psychosis and antipsychotic treatment response, but few studies have considered differential involvement of the caudate and putamen. This study's goals were twofold. First, identify patterns of dorsal striatal dysconnectivity for the caudate and putamen separately in patients with a psychosis spectrum disorder; second, determine if these dysconnectivity patterns were predictive of treatment response.Methods: Using resting state functional connectivity, we evaluated dorsal striatal connectivity using separate bilateral caudate and putamen seed regions in two cohorts of subjects: a cohort of 71 medication-naïve first episode psychosis patients and a cohort of 42 unmedicated patients with schizophrenia (along with matched controls).Patient and control connectivity maps were contrasted for each cohort. After receiving 6 weeks of risperidone treatment, patients' clinical response was calculated. We used regression analyses to determine the relationship between baseline dysconnectivity and treatment response.Results: This dysconnectivity was also predictive of treatment response in both cohorts.Discussion: These findings suggest that the caudate may be more of a driving factor than the putamen in early cortico-striatal dysconnectivity.

Objectives As definitive data from randomized controlled trials comparing the effect on long-term survival of using single or bilateral internal mammary artery grafting are not yet available, observational studies allow for long-term follow-up in large and representative populations, which might complement the information potentially derived from randomized trials. To compare long-term survival in patients under 70 years of age undergoing single or bilateral internal mammary artery grafting. Methods Retrospective analysis of 3384 consecutive patients under 70 years undergoing primary isolated coronary artery bypass surgery, performed from 2000 to 2015, in a Portuguese level III Hospital. We identified 2176 and 1208 patients from the study population that underwent single and bilateral internal mammary artery grafting, respectively. The primary end-point was all-cause mortality at ten years. We employed inverse probability weighting to restrict confounding by indication. Results The mean age of the study population was 59.4 (± 7.6) years, and 567 (16.8%) were females. Inverse probability weighting was effective in eliminating differences in all significant baseline characteristics. Follow-up was 99.88% complete. The median follow-up time was 12.82 (interquartile range, 9.65, 16.74) years: The primary end-point of all-cause mortality at ten years occurred in 463 patients (21.3%) and 166 (13.7%) in the single and bilateral internal mammary artery grafting group, respectively (hazard ratio, 0.78; 95% CI, 0.66 to 0.92; p = 0.004). Conclusions Bilateral internal mammary grafting is associated with lower long-term mortality than single internal mammary grafting. Moreover, this survival benefit comes at no increased perioperative morbidity or mortality cost.