Neuroimaging-based brain-age prediction of first-episode schizophrenia and the alteration of brain age after early medication

Abstract

Background Neuroimaging- and machine-learning-based brain-age prediction of schizophrenia is well established. However, the diagnostic significance and the effect of early medication on first-episode schizophrenia remains unclear. Aims To explore whether predicted brain age can be used as a biomarker for schizophrenia diagnosis, and the relationship between clinical characteristics and brain-predicted age difference (PAD), and the effects of early medication on predicted brain age. Method The predicted model was built on 523 diffusion tensor imaging magnetic resonance imaging scans from healthy controls. First, the brain-PAD of 60 patients with first-episode schizophrenia, 60 healthy controls and 21 follow-up patients from the principal data-set and 40 pairs of individuals in the replication data-set were calculated. Next, the brain-PAD between groups were compared and the correlations between brain-PAD and clinical measurements were analysed. Results The patients showed a significant increase in brain-PAD compared with healthy controls. After early medication, the brain-PAD of patients decreased significantly compared with baseline (P < 0.001). The fractional anisotropy value of 31/33 white matter tract features, which related to the brain-PAD scores, had significantly statistical differences before and after measurements (P < 0.05, false discovery rate corrected). Correlation analysis showed that the age gap was negatively associated with the positive score on the Positive and Negative Syndrome Scale in the principal data-set (r = −0.326, P = 0.014). Conclusions The brain age of patients with first-episode schizophrenia may be older than their chronological age. Early medication holds promise for improving the patient's brain ageing. Neuroimaging-based brain-age prediction can provide novel insights into the understanding of schizophrenia.

Predicting aging trajectories of decline in brain volume, cortical thickness and fractional anisotropy in schizophrenia

“…However, in the present study, we did not focus on specific brain regions to explore the alterations in brain structures caused by antipsychotic medication use in individuals with schizophrenia. A recent study 52 showed that early antipsychotic medication use might reduce the brain age gap in patients with first-episode schizophrenia. In contrast, the illness duration of the participants was longer in our study (mean: 15.56 years, ranging from 0 to 38 years), and our result showed a lack of association between medication and the brain age gap, which is consistent with the previous studies 17,18,23 .…”

Baseline white matter function predicts short‐term treatment response in first‐episode schizophrenia

“…The comparison between remission and nonremission groups after medication indicated a significant difference in white matter tract integrity at baseline 18 . Antipsychotics can regulate the plasticity of white matter structure 19 . White matter deficits involved in SZ neurodevelopment are associated with a higher risk of treatment resistance, 20 which demonstrates the prediction of the therapeutic effect of antipsychotic drugs from the perspective of white matter function.…”

“…18 Antipsychotics can regulate the plasticity of white matter structure. 19 White matter deficits involved in SZ neurodevelopment are associated with a higher risk of treatment resistance, 20 which demonstrates the prediction of the therapeutic effect of antipsychotic drugs from the perspective of white matter function. Furthermore, recent studies reported that white matter might be a viable pharmacological target of SZ, and white matter target therapies for SZ are currently being developed.…”

Brain Age Prediction Using 2D Projections Based on Higher-Order Statistical Moments and Eigenslices from 3D Magnetic Resonance Imaging Volumes

“…Other researchers have suggested that brain age is correlated with hypertension [8] and severity of depression [9,10], and that it is also predictive of the success of certain interventions for chronic pain [11]. Furthermore, an inflated brain age associated with schizophrenia has been shown to be partly reversed at the onset of medication [12,13]. There are a few recent review articles that give a more thorough explanation of the subject [14][15][16].…”