White matter integrity and symptom dimensions of schizophrenia: A diffusion tensor imaging study

Bopp, Miriam; Zöllner, Rebecca; Jansen, Andreas; Dietsche, Bruno; Krug, Axel; Kircher, Tilo

doi:10.1016/j.schres.2016.11.045

Cited by 53 publications

(32 citation statements)

References 125 publications

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“…We found lower FA values in five brain regions in FEDN schizophrenia patients than healthy controls, suggesting that the FA abnormalities are present even at the early course of first-episode schizophrenia 49 . Our result of widespread low FA in 5 brain regions in FEDN schizophrenia patients is consistent with the majority of the studies evaluating FA values in chronic patients with schizophrenia, as well as in first-episode schizophrenia 20,26,28,32,42,44,50–54 . However, some other studies failed to find any difference in FA values between FEDN patients and healthy controls 55–57 , or even higher FA values in schizophrenia 51 .…”

Section: Discussionsupporting

confidence: 91%

“…The disconnection within and between brain regions has long been proposed to explain the brain pathology associated with schizophrenia 16 . Gray matter regions (“neurons”) are connected by white matter (WM) (“axons”; fiber bundles), but the disruption in WM integrity may be the core basis for this disconnection of brain regions in schizophrenia 17–20 . At the present, in vivo WM structure is typically assessed by fractional anisotropy (FA) using diffusion tensor imaging (DTI) 21 .…”

Section: Introductionmentioning

confidence: 99%

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Sex difference in association of symptoms and white matter deficits in first-episode and drug-naive schizophrenia

et al. 2018

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Accumulating evidence shows that disruption of white matter (WM) may be involved in the pathophysiology of schizophrenia, even at the onset of psychosis. However, very few studies have explored sex difference in its association with psychopathology in schizophrenia. This study aims to compare sex differences in clinical features and WM abnormalities in first-episode and drug-naive (FEDN) schizophrenia among Han Chinese inpatients. The WM fractional anisotropy (FA) values of the whole-brain were determined using voxel-based diffusion tensor imaging (DTI) in 39 (16 males and 23 females) FEDN patients with schizophrenia and 30 healthy controls (13 males and 17 females) matched for gender, age, and education. Patient psychopathology was assessed using the Positive and Negative Syndrome Scale (PANSS).Our results showed that compared with the controls, the patients showed widespread areas of lower FA, including corpus callosum, brainstem, internal capsule, cingulate, and cerebellum (all adjusted p < 0.01). Further, male patients showed lower FA values in left cingulate (F = 4.92, p = 0.033), but higher scores on the PANSS total, positive, and general psychopathology subscale scores (all p < 0.01) than female patients. Multivariate regression analysis showed that for male patients, FA values in right corpus callosum were positively associated with the PANSS total (beta = 0.785, t = 3.76, p = 0.002) and the negative symptom scores (beta = 0.494, t = 2.20, p = 0.044), while for female patients, FA values in left cingulate were negatively associated with the PANSS positive symptom score (beta = −0.717, t = −2.25, p = 0.041). Our findings indicate sex difference in white matter disconnectivity and its association with psychopathological symptoms in an early course of schizophrenia onset.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Sex difference in association of symptoms and white matter deficits in first-episode and drug-naive schizophrenia

et al. 2018

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“…48 Auditory hallucinations of schizophrenia were also positively associated with disruption of corticospinal tract integrity, and alteration of this tract may relate to inner speech and efferent copy mechanisms. 49,50 The external capsule was one of the most frequently selected brain regions in both the fused multimodal features and single DTI measures. The external capsule, situated lateral to the internal capsule, contains association fiber tracts including the superior longitudinal fasciculus and inferior fronto-occipital fasciculus and commissural fibers.…”

Section: Classification Of First-episode Schizophreniamentioning

confidence: 99%

Classification of First-Episode Schizophrenia Using Multimodal Brain Features: A Combined Structural and Diffusion Imaging Study

Liang

Zhang

et al. 2018

Schizophrenia Bulletin

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Recent neuroanatomical pattern recognition studies have shown some promises for developing an objective neuroimaging-based classification related to schizophrenia. This study explored the feasibility of reliably identifying schizophrenia using single and multimodal multivariate neuroimaging features. Multiple brain measures including regional gray matter (GM) volume, cortical thickness, gyrification, fractional anisotropy (FA), and mean diffusivity (MD) were extracted using fully automated procedures. We used Gradient Boosting Decision Tree to identify the most frequently selected features of each set of neuroanatomical metric and fused multimodal measures. The current classification model was trained and validated based on 98 patients with first-episode schizophrenia (FES) and 106 matched healthy controls (HCs). The classification model was trained and tested in an independent dataset of 54 patients with FES and 48 HCs using imaging data acquired on a different magnetic resonance imaging scanner. Using the most frequently selected features from fused structural and diffusion tensor imaging metrics, a classification accuracy of 75.05% was achieved, which was higher than accuracy derived from a single imaging metric. Most prominent discriminative features included cortical thickness of left transverse temporal gyrus and right parahippocampal gyrus, the FA of left corticospinal tract and right external capsule. In the independent cohort, average accuracy was 76.54%, derived from combined features selected from cortical thickness, gyrification, FA, and MD. These features characterized by GM abnormalities and white matter disruptions have discriminative power with respect to the underlying pathological changes in the brain of individuals having schizophrenia. Our results further highlight the potential advantage of multimodal data fusion for identifying schizophrenia.

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“…In contrast, a lower WM directionality in language tracts increases vulnerability to positive FTDs [72]. Further studies have supported the particular link of FTDs to structural [79-81] and functional [41, 82-84] disorders of the language system.…”

Section: Mapping Symptoms Onto Brain Systems: Empirical Evidence For mentioning

confidence: 99%

Systems Neuroscience of Psychosis: Mapping Schizophrenia Symptoms onto Brain Systems

et al. 2017

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Schizophrenia research has been in a deadlock for many decades. Despite important advances in clinical treatment, there are still major concerns regarding long-term psychosocial reintegration and disease management, biological heterogeneity, unsatisfactory predictors of individual course and treatment strategies, and a confusing variety of controversial theories about its etiology and pathophysiological mechanisms. In the present perspective on schizophrenia research, we first discuss a methodological pitfall in contemporary schizophrenia research inherent in the attempt to link mental phenomena with the brain: we claim that the time-honored phenomenological method of defining mental symptoms should not be contaminated with the naturalistic approach of modern neuroscience. We then describe our Systems Neuroscience of Psychosis (SyNoPsis) project, which aims to overcome this intrinsic problem of psychiatric research. Considering schizophrenia primarily as a disorder of interindividual communication, we developed a neurobiologically informed semiotics of psychotic disorders, as well as an operational clinical rating scale. The novel psychopathology allows disentangling the clinical manifestations of schizophrenia into behavioral domains matching the functions of three well-described higher-order corticobasal brain systems involved in interindividual human communication, namely, the limbic, associative, and motor loops, including their corticocortical sensorimotor connections. The results of several empirical studies support the hypothesis that the proposed three-dimensional symptom structure, segregated into the affective, the language, and the motor domain, can be specifically mapped onto structural and functional abnormalities of the respective brain systems. New pathophysiological hypotheses derived from this brain system-oriented approach have helped to develop and improve novel treatment strategies with noninvasive brain stimulation and practicable clinical parameters. In clinical practice, the novel psychopathology allows confining the communication deficits of the individual patient, shifting attention from the symptoms to the intact resources. We have studied this approach and observed important advantages for therapeutic alliances, personalized treatment, and de-escalation strategies. Future studies will further conjoin clinical definitions of psychotic symptoms with brain structures and functions, and disentangle structural and functional deficit patterns within these systems to identify neurobiologically distinct subsyndromes. Neurobiologically homogeneous patient groups may provide new momentum for treatment research. Finally, lessons learned from schizophrenia research may contribute to developing a comprehensive perspective on human experience and behavior that integrates methodologically distinct, but internally consistent, insights from humanities and neuroscience.

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White matter integrity and symptom dimensions of schizophrenia: A diffusion tensor imaging study

Cited by 53 publications

References 125 publications

Sex difference in association of symptoms and white matter deficits in first-episode and drug-naive schizophrenia

Sex difference in association of symptoms and white matter deficits in first-episode and drug-naive schizophrenia

Classification of First-Episode Schizophrenia Using Multimodal Brain Features: A Combined Structural and Diffusion Imaging Study

Systems Neuroscience of Psychosis: Mapping Schizophrenia Symptoms onto Brain Systems

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