Patterns of Brain Structural Changes in First-Contact, Antipsychotic Drug-Naive Patients with Schizophrenia.

BACKGROUND AND PURPOSE: Previous studies have suggested that structural changes do occur in the brain of patients with schizophrenia
compared with healthy control participants. However, findings from such studies are inconclusive, probably because of the
different methodologic approaches, the clinical heterogeneity of patient samples, and also the fact that patients enrolled were treated
with antipsychotic drugs. The aim of this study was to investigate brain GM volumes and intrinsic structuralWMchanges in first-contact,
antipsychotic drug-naı ¨ve patients with schizophrenia.
MATERIALS AND METHODS: A total of 43 first-contact, drug-naı ¨ve, patients with schizophrenia and 17 age-matched control participants
were studied. All participants underwent T1-weighted MR imaging and DTI scans. Voxel-based morphometry and tract-based spatial
statistics were used to compare GM volumes and WM DTI metrics between groups. MR imaging measures were correlated with the
duration of the untreated psychosis and the clinical positive and negative symptoms.
RESULTS: Compared with control participants, patients with schizophrenia showed smaller volumes of the temporal, parietal, and
occipital GM, and a pattern of decreased mean diffusivity and increased fractional anisotropy in the brain stem and cerebellum bilaterally,
interhemispheric and cortico-cortical connections bilaterally, and right anterior and posterior limb of the internal capsule. In patients,
decreased mean diffusivity and increased fractional anisotropy in several brain regions were related to a longer duration of the untreated
psychosis and the severity of positive symptoms.
CONCLUSIONS: First-contact, drug-naı ¨ve, patients with schizophrenia present with volumetric and DTI changes, which correlated with their
clinical features. This study increases our knowledge on the neural networks involved in the pathophysiologic mechanisms of schizophrenia.