J Fitzsimmons1, H M Hamoda2, T Swisher3, D Terry3, G Rosenberger4, L J Seidman5, J Goldstein6, R Mesholam-Gately7, T Petryshen8, J Wojcik7, R Kikinis9, M Kubicki9. 1. Psychiatry Neuroimaging Laboratory, Departments of Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States. Electronic address: jfitzsimmons@bwh.harvard.edu. 2. Psychiatry Neuroimaging Laboratory, Departments of Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States; Department of Psychiatry, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States. 3. Psychiatry Neuroimaging Laboratory, Departments of Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States. 4. Psychiatry Neuroimaging Laboratory, Departments of Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States; Department of General Psychiatry, Medical University Innsbruck, Innsbruck, Austria. 5. Beth Israel Deaconess Medical Center, Massachusetts Mental Health Center, Public Psychiatry Division, Harvard Medical School, Boston, MA, United States; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States. 6. Beth Israel Deaconess Medical Center, Massachusetts Mental Health Center, Public Psychiatry Division, Harvard Medical School, Boston, MA, United States; Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States. 7. Beth Israel Deaconess Medical Center, Massachusetts Mental Health Center, Public Psychiatry Division, Harvard Medical School, Boston, MA, United States. 8. Stanley Center of Psychiatry Research, Broad Institute of MIT and Harvard, Boston, MA, United States; Psychiatry and Neurodevelopmental Genetics Unit, Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA, United States. 9. Surgical Planning Laboratory, MRI Division, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.
Abstract
BACKGROUND: The fornix is a compact bundle of white matter fibers that project from the hippocampus to the mamillary bodies and septal nuclei. Its association with memory, as well as with symptoms in schizophrenia, has been reported in chronic schizophrenia. The purpose of this study is to determine whether or not fornix abnormalities are evident at the onset of schizophrenia. METHODS: Diffusion tensor imaging (DTI) and DT tractography were used to evaluate the fornix in 21 patients with first episode schizophrenia (16 males/5 females) and 22 healthy controls (13 males/9 females). Groups were matched on age, gender, parental socioeconomic status, education and handedness. Fractional anisotropy (FA), a measure of white matter integrity, radial diffusivity (RD), thought to reflect myelin integrity, trace, a possible marker of atrophy or cell loss, and axial diffusivity (AD), thought to reflect axonal integrity, were averaged over the entire tract extracted by means of DT tractography, and used to investigate fornix abnormalities in first episode schizophrenia compared with healthy controls. RESULTS: Significant group differences were found between first episode patients and controls for FA (p=0.0001), RD (p=0.001) and trace (p=0.006). CONCLUSION: These findings suggest abnormalities in the fornix in the early stages of schizophrenia, and further suggest that white matter abnormalities, which are apparent in the early course of the disease, may reflect myelin disturbances.
BACKGROUND: The fornix is a compact bundle of white matter fibers that project from the hippocampus to the mamillary bodies and septal nuclei. Its association with memory, as well as with symptoms in schizophrenia, has been reported in chronic schizophrenia. The purpose of this study is to determine whether or not fornix abnormalities are evident at the onset of schizophrenia. METHODS: Diffusion tensor imaging (DTI) and DT tractography were used to evaluate the fornix in 21 patients with first episode schizophrenia (16 males/5 females) and 22 healthy controls (13 males/9 females). Groups were matched on age, gender, parental socioeconomic status, education and handedness. Fractional anisotropy (FA), a measure of white matter integrity, radial diffusivity (RD), thought to reflect myelin integrity, trace, a possible marker of atrophy or cell loss, and axial diffusivity (AD), thought to reflect axonal integrity, were averaged over the entire tract extracted by means of DT tractography, and used to investigate fornix abnormalities in first episode schizophrenia compared with healthy controls. RESULTS: Significant group differences were found between first episode patients and controls for FA (p=0.0001), RD (p=0.001) and trace (p=0.006). CONCLUSION: These findings suggest abnormalities in the fornix in the early stages of schizophrenia, and further suggest that white matter abnormalities, which are apparent in the early course of the disease, may reflect myelin disturbances.
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