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Brain free water alterations in first-episode psychosis: a longitudinal analysis of diagnosis, course of illness, and medication effects

Published online by Cambridge University Press:  08 January 2020

J. Y. Guo Open the ORCID record for J. Y. Guo [Opens in a new window] ,
T. A. Lesh ,
T. A. Niendam ,
J. D. Ragland ,
L. M. Tully  and
C. S. Carter
J. Y. Guo
Affiliation:
Imaging Research Center, the University of California at Davis, Sacramento, CA, USA Center for Neuroscience, the University of California at Davis, Davis, CA, USA
T. A. Lesh
Affiliation:
Imaging Research Center, the University of California at Davis, Sacramento, CA, USA Psychiatry and Behavioral Sciences, University of California, Davis, CA, USA
T. A. Niendam
Affiliation:
Imaging Research Center, the University of California at Davis, Sacramento, CA, USA Psychiatry and Behavioral Sciences, University of California, Davis, CA, USA
J. D. Ragland
Affiliation:
Imaging Research Center, the University of California at Davis, Sacramento, CA, USA Psychiatry and Behavioral Sciences, University of California, Davis, CA, USA
L. M. Tully
Affiliation:
Imaging Research Center, the University of California at Davis, Sacramento, CA, USA Psychiatry and Behavioral Sciences, University of California, Davis, CA, USA
C. S. Carter*
Affiliation:
Imaging Research Center, the University of California at Davis, Sacramento, CA, USA Center for Neuroscience, the University of California at Davis, Davis, CA, USA Psychiatry and Behavioral Sciences, University of California, Davis, CA, USA
*
Author for correspondence: C. S. Carter, E-mail: [email protected]
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Abstract

Background

Multiple lines of evidence suggest the presence of altered neuroimmune processes in patients with schizophrenia (Sz) and severe mood disorders. Recent studies using a novel free water diffusion tensor imaging (FW DTI) approach, proposed as a putative biomarker of neuroinflammation, atrophy, or edema, have shown significantly increased FW in patients with Sz. However no studies to date have investigated the longitudinal stability of FW alterations during the early course of psychosis, nor have studies focused separately on FE psychosis patients with Sz or bipolar disorder (BD) with psychotic features.

Methods

The current study included 188 participants who underwent diffusion magnetic resonance imaging scanning at baseline. Sixty-four participants underwent follow-up rescanning after 12 months. DTI-based alterations in patients were calculated using voxelwise tract-based spatial statistics and region of interest analyses.

Results

Patients with FE psychosis, both Sz and BD, exhibited increased FW at illness onset which remained unchanged over the 12-month follow-up period. Preliminary analyses suggested that antipsychotic medication exposure was associated with higher FW in gray matter that reached significance in the BD group. Higher FW in white matter correlated with negative symptom severity.

Conclusions

Our results support the presence of elevated FW at the onset of psychosis in both Sz and BD, which remains stable during the early course of the illness, with no evidence of either progression or remission.

Keywords

DTIfirst episode psychosisFWputative neuroinflammatory biomarker
Type
Original Articles
Information
Psychological Medicine , Volume 51 , Issue 6 , April 2021 , pp. 1001 - 1010
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Copyright
Copyright © Cambridge University Press 2020

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