Two patterns of white matter abnormalities in medication-naive patients with first-episode schizophrenia revealed by diffusion tensor imaging and cluster analysis

Huaiqiang Sun, Su Lui, Li Yao, Wei Deng, Yuan Xiao, Wenjing Zhang, Xiaoqi Huang, Junmei Hu, Feng Bi, Tao Li, John A. Sweeney, Qiyong Gong

Research output: Contribution to journalArticlepeer-review

76 Scopus citations

Abstract

IMPORTANCE Accumulating evidence supports the hypothesis that cerebral white matter abnormalities are involved in the pathophysiology of schizophrenia; however, findings from in vivo neuroimaging studies have been inconsistent. Besides confounding factors, including age, illness duration, and medication effects, an additional cause for the inconsistent results may be heterogeneity in the nature of white matter alterations associated with the disorder. OBJECTIVE To investigate whether different patterns of white matter abnormalities exist in a large cohort of medication-naive patients with first-episode schizophrenia and the relationship between such patterns and clinical parameters. DESIGN, SETTING, AND PARTICIPANTS A cross-sectional diffusion tensor imaging study of 113 medication-naive patients with first-episode schizophrenia and 110 demographically matched healthy control individuals. The study was conducted in the mental health center of West China Hospital, Sichuan University, Chengdu, China, from January 2006 to June 2014. MAIN OUTCOMES AND MEASURES The patterns of white matter abnormalities revealed by tract-specific analysis in conjunction with hierarchical clustering. RESULTS With diffusion features extracted from 18 fiber tracts, cluster analysis revealed 2 patterns of abnormalities. One pattern (42.5%of patient sample) showed widespread white matter abnormalities compared with matched healthy control individuals, while another pattern (57.5%of patient sample) only showed circumscribed regional white matter abnormalities, mainly in the left superior longitudinal fasciculus. Patients in these subgroups did not differ in demographic features; however, negative symptoms were more severe in patients with widespread white matter abnormalities. CONCLUSIONS AND RELEVANCE Two distinct patterns of white matter abnormalities exist at the early phase of schizophrenia, with those having global abnormalities experiencing more severe negative symptoms. The finding that distinct subgroups of patients with schizophrenia have different forms of white matter pathologymay reflect qualitatively distinct genetic influences or neurodevelopmental alterations and thus represents a promising strategy for resolving neurobiological heterogeneity in the schizophrenia syndrome

Original languageEnglish (US)
Pages (from-to)678-686
Number of pages9
JournalJAMA Psychiatry
Volume72
Issue number7
DOIs
StatePublished - Jul 1 2015

ASJC Scopus subject areas

  • Psychiatry and Mental health

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