BACKGROUND: Abnormalities of the anterior cingulate cortex (ACC) are frequently implicated in the pathophysiology of psychotic disorders, but whether such changes are apparent before psychosis onset remains unclear. In this study, we characterized prepsychotic ACC abnormalities in a sample of individuals at ultra-high-risk (UHR) for psychosis. METHODS: Participants underwent baseline magnetic resonance imaging and were followed-up over 12-24 months to ascertain diagnostic outcomes. Baseline ACC morphometry was then compared between UHR individuals who developed psychosis (UHR-P; n = 35), those who did not (UHR-NP; n = 35), and healthy control subjects (n = 33). RESULTS: Relative to control subjects, UHR-P individuals displayed bilateral thinning of a rostral paralimbic ACC region that was negatively correlated with negative symptoms, whereas UHR-NP individuals displayed a relative thickening of dorsal and rostral limbic areas that was correlated with anxiety ratings. Baseline ACC differences between the two UHR groups predicted time to psychosis onset, independently of symptomatology. Subdiagnostic comparisons revealed that changes in the UHR-P group were driven by individuals subsequently diagnosed with a schizophrenia spectrum psychosis. CONCLUSIONS: These findings indicate that anatomic abnormalities of the ACC precede psychosis onset and that baseline ACC differences distinguish between UHR individuals who do and do not subsequently develop frank psychosis. They also indicate that prepsychotic changes are relatively specific to individuals who develop a schizophrenia spectrum disorder, suggesting they may represent a diagnostically specific risk marker.
BACKGROUND: Abnormalities of the anterior cingulate cortex (ACC) are frequently implicated in the pathophysiology of psychotic disorders, but whether such changes are apparent before psychosis onset remains unclear. In this study, we characterized prepsychotic ACC abnormalities in a sample of individuals at ultra-high-risk (UHR) for psychosis. METHODS:Participants underwent baseline magnetic resonance imaging and were followed-up over 12-24 months to ascertain diagnostic outcomes. Baseline ACC morphometry was then compared between UHR individuals who developed psychosis (UHR-P; n = 35), those who did not (UHR-NP; n = 35), and healthy control subjects (n = 33). RESULTS: Relative to control subjects, UHR-P individuals displayed bilateral thinning of a rostral paralimbic ACC region that was negatively correlated with negative symptoms, whereas UHR-NP individuals displayed a relative thickening of dorsal and rostral limbic areas that was correlated with anxiety ratings. Baseline ACC differences between the two UHR groups predicted time to psychosis onset, independently of symptomatology. Subdiagnostic comparisons revealed that changes in the UHR-P group were driven by individuals subsequently diagnosed with a schizophrenia spectrum psychosis. CONCLUSIONS: These findings indicate that anatomic abnormalities of the ACC precede psychosis onset and that baseline ACC differences distinguish between UHR individuals who do and do not subsequently develop frank psychosis. They also indicate that prepsychotic changes are relatively specific to individuals who develop a schizophrenia spectrum disorder, suggesting they may represent a diagnostically specific risk marker.
Authors: Tim B Ziermans; Patricia F Schothorst; Hugo G Schnack; P Cédric M P Koolschijn; René S Kahn; Herman van Engeland; Sarah Durston Journal: Schizophr Bull Date: 2010-10-07 Impact factor: 9.306
Authors: Stefano Marenco; Antonina A Savostyanova; Jan Willem van der Veen; Matthew Geramita; Alexa Stern; Alan S Barnett; Bhaskar Kolachana; Eugenia Radulescu; Fengyu Zhang; Joseph H Callicott; Richard E Straub; Jun Shen; Daniel R Weinberger Journal: Neuropsychopharmacology Date: 2010-03-31 Impact factor: 7.853
Authors: Paola Dazzan; Bridget Soulsby; Andrea Mechelli; Stephen J Wood; Dennis Velakoulis; Lisa J Phillips; Alison R Yung; Xavier Chitnis; Ashleigh Lin; Robin M Murray; Patrick D McGorry; Philip K McGuire; Christos Pantelis Journal: Schizophr Bull Date: 2011-04-25 Impact factor: 9.306
Authors: Wi Hoon Jung; June Sic Kim; Joon Hwan Jang; Jung-Seok Choi; Myung Hun Jung; Ji-Young Park; Ji Yeon Han; Chi-Hoon Choi; Do-Hyung Kang; Chun Kee Chung; Jun Soo Kwon Journal: Schizophr Bull Date: 2009-12-21 Impact factor: 9.306
Authors: Matcheri S Keshavan; Shreedhar Kulkarni; Tejas Bhojraj; Alan Francis; Vaibhav Diwadkar; Debra M Montrose; Larry J Seidman; John Sweeney Journal: Front Hum Neurosci Date: 2010-03-09 Impact factor: 3.169