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First-episode psychosis is characterized by failure of deactivation but not by hypo- or hyperfrontality

Published online by Cambridge University Press:  07 July 2011

A. Guerrero-Pedraza ,
P. J. McKenna ,
J. J. Gomar ,
S. Sarró ,
R. Salvador ,
B. Amann ,
M. I. Carrión ,
R. Landin-Romero ,
J. Blanch  and
E. Pomarol-Clotet
A. Guerrero-Pedraza
Affiliation:
Benito Menni CASM, Barcelona, Spain Psychiatry and Clinical Psychology Programme, Universitat Autònoma de Barcelona, Spain
P. J. McKenna
Affiliation:
Benito Menni CASM, Barcelona, Spain FIDMAG, Germanes Hospitàries and CIBERSAM, Spain
J. J. Gomar
Affiliation:
Psychiatry and Clinical Psychology Programme, Universitat Autònoma de Barcelona, Spain FIDMAG, Germanes Hospitàries and CIBERSAM, Spain
S. Sarró
Affiliation:
Psychiatry and Clinical Psychology Programme, Universitat Autònoma de Barcelona, Spain FIDMAG, Germanes Hospitàries and CIBERSAM, Spain
R. Salvador
Affiliation:
FIDMAG, Germanes Hospitàries and CIBERSAM, Spain
B. Amann
Affiliation:
Benito Menni CASM, Barcelona, Spain FIDMAG, Germanes Hospitàries and CIBERSAM, Spain
M. I. Carrión
Affiliation:
Hospital Sant Rafael, Barcelona, Spain
R. Landin-Romero
Affiliation:
FIDMAG, Germanes Hospitàries and CIBERSAM, Spain
J. Blanch
Affiliation:
Hospital Sant Joan de Déu infantil, Barcelona, Spain
E. Pomarol-Clotet*
Affiliation:
FIDMAG, Germanes Hospitàries and CIBERSAM, Spain
*
*Address for correspondence: Dr E. Pomarol-Clotet, Benito Menni CASM, Germanes Hospitalàries del Sagrat Cor de Jesús, C/ Dr Antoni Pujadas 38-C, 08830 Sant Boi de Llobregat, Barcelona, Spain. (Email: [email protected])
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Abstract

Background

It is not known whether first-episode psychosis is characterized by the same prefrontal cortex functional imaging abnormalities as chronic schizophrenia.

Method

Thirty patients with a first episode of non-affective functional psychosis and 28 healthy controls underwent functional magnetic resonance imaging (fMRI) during performance of the n-back working memory task. Voxel-based analyses of brain activations and deactivations were carried out and compared between groups. The connectivity of regions of significant difference between the patients and controls was also examined.

Results

The first-episode patients did not show significant prefrontal hypo- or hyperactivation compared to controls. However, they showed failure of deactivation in the medial frontal cortex. This area showed high levels of connectivity with the posterior cingulate gyrus/precuneus and parts of the parietal cortex bilaterally. Failure of deactivation was significantly greater in first-episode patients who had or went on to acquire a DSM-IV diagnosis of schizophrenia than in those who did not, and in those who met RDC criteria for schizophrenia compared to those who did not.

Conclusions

First-episode psychosis is not characterized by hypo- or hyperfrontality but instead by a failure of deactivation in the medial frontal cortex. The location and connectivity of this area suggest that it is part of the default mode network. The failure of deactivation seems to be particularly marked in first-episode patients who have, or progress to, schizophrenia.

Keywords

Default mode networkfirst-episode psychosisfunctional imagingschizophrenia
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 1 , January 2012 , pp. 73 - 84
Copyright
Copyright © Cambridge University Press 2011

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