Elsevier

Biological Psychiatry

Volume 85, Issue 1, 1 January 2019, Pages 70-78
Biological Psychiatry

Archival Report
Microstructural Changes in Higher-Order Nuclei of the Thalamus in Patients With First-Episode Psychosis

https://doi.org/10.1016/j.biopsych.2018.05.019Get rights and content

Abstract

Background

Disruption in the thalamus, such as volume, shape, and cortical connectivity, is regarded as an important pathophysiological mechanism in schizophrenia. However, there is little evidence of nuclei-specific structural alterations in the thalamus during early-stage psychosis, mainly because of the methodological limitations of conventional structural imaging in identifying the thalamic nuclei.

Methods

A total of 37 patients with first-episode psychosis and 36 matched healthy control subjects underwent diffusion tensor imaging, diffusion kurtosis imaging, and T1-weighted magnetic resonance imaging. Connectivity-based segmentation of the thalamus was performed using diffusion tensor imaging, and averages of the diffusion kurtosis values, which represent microstructural complexity, were estimated using diffusion kurtosis imaging and were compared in each thalamic nucleus between the groups.

Results

The mean kurtosis values in the thalamic regions with strong connections to the orbitofrontal cortex (F1,70 = 8.40, p < .01) and the lateral temporal cortex (F1,70 = 8.46, p < .01) were significantly reduced in patients with first-episode psychosis compared with those of the healthy control subjects. The mean kurtosis values in the thalamic region with strong connection to the orbitofrontal cortex showed a significant correlation with spatial working memory accuracy in patients with first-episode psychosis (r = .36, p < .05), whereas no significant correlation between these variables was observed in the healthy control subjects.

Conclusions

The observed pattern of reduced microstructural complexity in the nuclei not only highlights the involvement of the thalamus but also emphasizes the role of the higher-order nuclei in the pathophysiology beginning in the early stage of schizophrenia.

Section snippets

Methods and Materials

Thirty-seven patients with FEP were selected, between April 2010 and June 2014, from a slightly larger pool of patients who visited Seoul National University Hospital for their symptoms and agreed to participate in the research. Intensive clinical interviews were conducted for all patients with FEP by experienced psychiatrists, using the Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID-I) to identify past and current psychiatric illnesses. The inclusion criteria were age

Results

There were no significant differences in the demographic backgrounds between the patients with FEP and the HCs, except for their IQ scores (t71 = 2.86, p < .05) (Table 1).

The results of ANCOVA of the MKs are summarized in Table 2. There was a significant group effect on the MKs, in which patients with FEP exhibited reduced MKs in the thalamic ROIs with the strongest connections to the OFC (F1,70 = 8.40, p < .01) and the LTC (F1,70 = 8.46, p < .005). The group effect on other thalamic nuclei did

Discussion

To our knowledge, this is the first study to report nuclei-specific microstructural alterations in the thalamus of patients with FEP. Our results revealed significantly reduced microstructural complexity in the thalamic regions with strong connections to the OFC and LTC in patients with FEP. By using measures of microstructure in vivo, our results could show that the nuclei-specific abnormalities in the thalamus exist from the early stages of the disorder, findings that have been somewhat

Acknowledgments and Disclosures

This research was supported by the Brain Research Program through the National Research Foundation of Korea funded by the Ministry of Science, Information and Communication Technologies, and Future Planning (Grant No. 2017M3C7A1029610 [to JSK]). The authors report no biomedical financial interests or potential conflicts of interest.

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