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A longitudinal study of cortical changes and their cognitive correlates in patients followed up after first-episode psychosis

Published online by Cambridge University Press:  03 July 2014

L. Gutiérrez-Galve ,
E. M. Chu ,
V. C. Leeson ,
G. Price ,
T. R. E. Barnes ,
E. M. Joyce  and
M. A. Ron
L. Gutiérrez-Galve*
Affiliation:
University College London, Queen Square, London, UK Imperial College Faculty of Medicine, St Mary's Campus, London, UK Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación, Madrid, Spain
E. M. Chu
Affiliation:
University College London, Queen Square, London, UK
V. C. Leeson
Affiliation:
Imperial College Faculty of Medicine, Charing Cross Campus, London, UK
G. Price
Affiliation:
University College London, Queen Square, London, UK
T. R. E. Barnes
Affiliation:
Imperial College Faculty of Medicine, Charing Cross Campus, London, UK
E. M. Joyce
Affiliation:
University College London, Queen Square, London, UK
M. A. Ron
Affiliation:
University College London, Queen Square, London, UK
*
*Address for correspondence: Dr L. Gutiérrez-Galve, Academic Unit of Child and Adolescent Psychiatry, 3rd floor QEQM Building, Imperial College, St Mary's Campus, Norfolk Place, London W2 1PG, UK. (Email: [email protected])
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Abstract

Background

Loss of cortical volume in frontotemporal regions occurs in patients with first-episode psychosis (FEP) and longitudinal studies have reported progressive brain volume changes at different stages of the disease, even if cognitive deficits remain stable over time. We investigated cortical changes in patients over the 2 years following their FEP and their associations with clinical and cognitive measures.

Method

Twenty-seven patients after their FEP (20 with schizophrenia, seven with schizo-affective disorder) and 25 healthy controls matched for age and gender participated in this study. Magnetic resonance imaging (MRI) was performed on a 1.5-T scanner both at baseline and after 2 years. Area and thickness of the cortex were measured using surface-based morphometry (SBM). Patients also underwent neuropsychological testing at these two time points.

Results

Progressive cortical thinning in the superior and inferior frontal and, to a lesser extent, superior temporal cortex was observed in patients. Cortical area remained constant. Cortical thinning was associated with duration of treatment at a trend level and was predicted by baseline measures of IQ and working memory. Cortical thinning occurred in the absence of clinical or cognitive deterioration.

Conclusions

The clinical implications of these cortical changes remain uncertain, but patients with less cognitive reserve may be more vulnerable to developing cortical abnormalities when exposed to medication or other disease-related biological factors.

Keywords

Cognitive impairmentcortical areacortical thicknessfirst-episode psychosisfollow-upmagnetic resonance imagingsurface-based morphometry
Type
Original Articles
Information
Psychological Medicine , Volume 45 , Issue 1 , January 2015 , pp. 205 - 216
Copyright
Copyright © Cambridge University Press 2014 

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