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White matter integrity as a predictor of response to treatment in first episode psychosis

Title: White matter integrity as a predictor of response to treatment in first episode psychosis
Author(s): Reis Marques, T
Taylor, H
Chaddock, C
Dell'acqua, F
Handley, R
Reinders, AA
Mondelli, V
Bonaccorso, S
Diforti, M
Simmons, A
David, AS
Murray, RM
Pariante, CM
Kapur, S
Dazzan, P
Item Type: Journal Article
Abstract: The integrity of brain white matter connections is central to a patient's ability to respond to pharmacological interventions. This study tested this hypothesis using a specific measure of white matter integrity, and examining its relationship to treatment response using a prospective design in patients within their first episode of psychosis. Diffusion tensor imaging data were acquired in 63 patients with first episode psychosis and 52 healthy control subjects (baseline). Response was assessed after 12 weeks and patients were classified as responders or non-responders according to treatment outcome. At this second time-point, they also underwent a second diffusion tensor imaging scan. Tract-based spatial statistics were used to assess fractional anisotropy as a marker of white matter integrity. At baseline, non-responders showed lower fractional anisotropy than both responders and healthy control subjects (P < 0.05; family-wise error-corrected), mainly in the uncinate, cingulum and corpus callosum, whereas responders were indistinguishable from healthy control subjects. After 12 weeks, there was an increase in fractional anisotropy in both responders and non-responders, positively correlated with antipsychotic exposure. This represents one of the largest, controlled investigations of white matter integrity and response to antipsychotic treatment early in psychosis. These data, together with earlier findings on cortical grey matter, suggest that grey and white matter integrity at the start of treatment is an important moderator of response to antipsychotics. These findings can inform patient stratification to anticipate care needs, and raise the possibility that antipsychotics may restore white matter integrity as part of the therapeutic response.
Publication Date: 19-Nov-2013
Date of Acceptance: 15-Sep-2013
URI: http://hdl.handle.net/10044/1/40543
DOI: http://dx.doi.org/10.1093/brain/awt310
ISSN: 1460-2156
Publisher: Oxford University Press
Start Page: 172
End Page: 182
Journal / Book Title: Brain
Volume: 137
Issue: 1
Copyright Statement: This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: antipsychotic drugs
diffusion tensor imaging
psychosis
schizophrenia
white matter
Adult
Anisotropy
Antipsychotic Agents
Brain
Diffusion Tensor Imaging
Female
Humans
Image Processing, Computer-Assisted
International Classification of Diseases
Longitudinal Studies
Male
Mental Disorders
Predictive Value of Tests
Psychotic Disorders
Young Adult
Brain
Humans
Antipsychotic Agents
Longitudinal Studies
Predictive Value of Tests
Mental Disorders
Psychotic Disorders
Anisotropy
Image Processing, Computer-Assisted
International Classification of Diseases
Adult
Female
Male
Young Adult
Diffusion Tensor Imaging
Neurology & Neurosurgery
11 Medical And Health Sciences
17 Psychology And Cognitive Sciences
Publication Status: Published
Appears in Collections:Clinical Sciences
Imaging Sciences
Faculty of Medicine



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