Symptom Remission and Brain Cortical Networks at First Clinical Presentation of Psychosis: The OPTiMiSE Study

Paola Dazzan; Andrew J Lawrence; Antje A T S Reinders; Alice Egerton; Neeltje E M Van Haren; Kate Merritt; Gareth J Barker; Rocio Perez-Iglesias; Kyra-Verena Sendt; Arsime Demjaha; Kie W Nam; Iris E Sommer; Christos Pantelis; W Wolfgang Fleischhacker; Inge Winter Van Rossum; Silvana Galderisi; Armida Mucci; Richard Drake; Shon Lewis; Mark Weiser; Covadonga M Martinez Diaz-Caneja; Joost Janssen; Marina Diaz-Marsa; Roberto Rodríguez-Jimenez; Celso Arango; Lone Baandrup; Brian Broberg; Egill Rostrup; Bjørn H Ebdrup; Birte Glenthøj; Rene S Kahn; Philip Mcguire

doi:10.1093/schbul/sbaa115

Symptom Remission and Brain Cortical Networks at First Clinical Presentation of Psychosis: The OPTiMiSE Study

Paola Dazzan, Andrew J Lawrence, Antje A T S Reinders, Alice Egerton, Neeltje E M Van Haren, Kate Merritt, Gareth J Barker, Rocio Perez-Iglesias, Kyra-Verena Sendt, Arsime Demjaha, Kie W Nam, Iris E Sommer, Christos Pantelis, W Wolfgang Fleischhacker, Inge Winter Van Rossum, Silvana Galderisi, Armida Mucci, Richard Drake, Shon Lewis, Mark WeiserCovadonga M Martinez Diaz-Caneja, Joost Janssen, Marina Diaz-Marsa, Roberto Rodríguez-Jimenez, Celso Arango, Lone Baandrup, Brian Broberg, Egill Rostrup, Bjørn H Ebdrup, Birte Glenthøj, Rene S Kahn, Philip Mcguire

Research output: Contribution to journal › Article › peer-review

7 Citations (Scopus)

Abstract

Individuals with psychoses have brain alterations, particularly in frontal and temporal cortices, that may be particularly prominent, already at illness onset, in those more likely to have poorer symptom remission following treatment with the first antipsychotic. The identification of strong neuroanatomical markers of symptom remission could thus facilitate stratification and individualized treatment of patients with schizophrenia. We used magnetic resonance imaging at baseline to examine brain regional and network correlates of subsequent symptomatic remission in 167 medication-naïve or minimally treated patients with first-episode schizophrenia, schizophreniform disorder, or schizoaffective disorder entering a three-phase trial, at seven sites. Patients in remission at the end of each phase were randomized to treatment as usual, with or without an adjunctive psycho-social intervention for medication adherence. The final follow-up visit was at 74 weeks. A total of 108 patients (70%) were in remission at Week 4, 85 (55%) at Week 22, and 97 (63%) at Week 74. We found no baseline regional differences in volumes, cortical thickness, surface area, or local gyrification between patients who did or did not achieved remission at any time point. However, patients not in remission at Week 74, at baseline showed reduced structural connectivity across frontal, anterior cingulate, and insular cortices. A similar pattern was evident in patients not in remission at Week 4 and Week 22, although not significantly. Lack of symptom remission in first-episode psychosis is not associated with regional brain alterations at illness onset. Instead, when the illness becomes a stable entity, its association with the altered organization of cortical gyrification becomes more defined.

Original language	English
Pages (from-to)	444-455
Number of pages	12
Journal	Schizophrenia Bulletin
Volume	47
Issue number	2
Early online date	15 Oct 2020
DOIs	https://doi.org/10.1093/schbul/sbaa115
Publication status	Published - 16 Mar 2021

Keywords

Schizophrenia
MRI
Gyrification
Trial
First episode
Cortical thickness
OPTiMiSE

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Dazzan, P., Lawrence, A. J., Reinders, A. A. T. S., Egerton, A., Van Haren, N. E. M., Merritt, K., Barker, G. J., Perez-Iglesias, R., Sendt, K.-V., Demjaha, A., Nam, K. W., Sommer, I. E., Pantelis, C., Wolfgang Fleischhacker, W., Van Rossum, I. W., Galderisi, S., Mucci, A., Drake, R., Lewis, S., ... Mcguire, P. (2021). Symptom Remission and Brain Cortical Networks at First Clinical Presentation of Psychosis: The OPTiMiSE Study. Schizophrenia Bulletin, 47(2), 444-455. https://doi.org/10.1093/schbul/sbaa115

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title = "Symptom Remission and Brain Cortical Networks at First Clinical Presentation of Psychosis: The OPTiMiSE Study",

abstract = "Individuals with psychoses have brain alterations, particularly in frontal and temporal cortices, that may be particularly prominent, already at illness onset, in those more likely to have poorer symptom remission following treatment with the first antipsychotic. The identification of strong neuroanatomical markers of symptom remission could thus facilitate stratification and individualized treatment of patients with schizophrenia. We used magnetic resonance imaging at baseline to examine brain regional and network correlates of subsequent symptomatic remission in 167 medication-na{\"i}ve or minimally treated patients with first-episode schizophrenia, schizophreniform disorder, or schizoaffective disorder entering a three-phase trial, at seven sites. Patients in remission at the end of each phase were randomized to treatment as usual, with or without an adjunctive psycho-social intervention for medication adherence. The final follow-up visit was at 74 weeks. A total of 108 patients (70%) were in remission at Week 4, 85 (55%) at Week 22, and 97 (63%) at Week 74. We found no baseline regional differences in volumes, cortical thickness, surface area, or local gyrification between patients who did or did not achieved remission at any time point. However, patients not in remission at Week 74, at baseline showed reduced structural connectivity across frontal, anterior cingulate, and insular cortices. A similar pattern was evident in patients not in remission at Week 4 and Week 22, although not significantly. Lack of symptom remission in first-episode psychosis is not associated with regional brain alterations at illness onset. Instead, when the illness becomes a stable entity, its association with the altered organization of cortical gyrification becomes more defined.",

keywords = "Schizophrenia, MRI, Gyrification, Trial, First episode, Cortical thickness, OPTiMiSE",

author = "Paola Dazzan and Lawrence, {Andrew J} and Reinders, {Antje A T S} and Alice Egerton and {Van Haren}, {Neeltje E M} and Kate Merritt and Barker, {Gareth J} and Rocio Perez-Iglesias and Kyra-Verena Sendt and Arsime Demjaha and Nam, {Kie W} and Sommer, {Iris E} and Christos Pantelis and {Wolfgang Fleischhacker}, W and {Van Rossum}, {Inge Winter} and Silvana Galderisi and Armida Mucci and Richard Drake and Shon Lewis and Mark Weiser and {Martinez Diaz-Caneja}, {Covadonga M} and Joost Janssen and Marina Diaz-Marsa and Roberto Rodr{\'i}guez-Jimenez and Celso Arango and Lone Baandrup and Brian Broberg and Egill Rostrup and Ebdrup, {Bj{\o}rn H} and Birte Glenth{\o}j and Kahn, {Rene S} and Philip Mcguire",

year = "2021",

month = mar,

day = "16",

doi = "10.1093/schbul/sbaa115",

language = "English",

volume = "47",

pages = "444--455",

journal = "Schizophrenia Bulletin",

issn = "0586-7614",

publisher = "Oxford University Press",

number = "2",

}

Dazzan, P , Lawrence, AJ , Reinders, AATS , Egerton, A, Van Haren, NEM, Merritt, K , Barker, GJ , Perez-Iglesias, R, Sendt, K-V, Demjaha, A , Nam, KW, Sommer, IE, Pantelis, C, Wolfgang Fleischhacker, W, Van Rossum, IW, Galderisi, S, Mucci, A, Drake, R, Lewis, S, Weiser, M, Martinez Diaz-Caneja, CM, Janssen, J, Diaz-Marsa, M, Rodríguez-Jimenez, R, Arango, C, Baandrup, L, Broberg, B, Rostrup, E, Ebdrup, BH, Glenthøj, B, Kahn, RS & Mcguire, P 2021, 'Symptom Remission and Brain Cortical Networks at First Clinical Presentation of Psychosis: The OPTiMiSE Study', Schizophrenia Bulletin, vol. 47, no. 2, pp. 444-455. https://doi.org/10.1093/schbul/sbaa115

TY - JOUR

T1 - Symptom Remission and Brain Cortical Networks at First Clinical Presentation of Psychosis: The OPTiMiSE Study

AU - Dazzan, Paola

AU - Lawrence, Andrew J

AU - Reinders, Antje A T S

AU - Egerton, Alice

AU - Van Haren, Neeltje E M

AU - Merritt, Kate

AU - Barker, Gareth J

AU - Perez-Iglesias, Rocio

AU - Sendt, Kyra-Verena

AU - Demjaha, Arsime

AU - Nam, Kie W

AU - Sommer, Iris E

AU - Pantelis, Christos

AU - Wolfgang Fleischhacker, W

AU - Van Rossum, Inge Winter

AU - Galderisi, Silvana

AU - Mucci, Armida

AU - Drake, Richard

AU - Lewis, Shon

AU - Weiser, Mark

AU - Martinez Diaz-Caneja, Covadonga M

AU - Janssen, Joost

AU - Diaz-Marsa, Marina

AU - Rodríguez-Jimenez, Roberto

AU - Arango, Celso

AU - Baandrup, Lone

AU - Broberg, Brian

AU - Rostrup, Egill

AU - Ebdrup, Bjørn H

AU - Glenthøj, Birte

AU - Kahn, Rene S

AU - Mcguire, Philip

PY - 2021/3/16

Y1 - 2021/3/16

N2 - Individuals with psychoses have brain alterations, particularly in frontal and temporal cortices, that may be particularly prominent, already at illness onset, in those more likely to have poorer symptom remission following treatment with the first antipsychotic. The identification of strong neuroanatomical markers of symptom remission could thus facilitate stratification and individualized treatment of patients with schizophrenia. We used magnetic resonance imaging at baseline to examine brain regional and network correlates of subsequent symptomatic remission in 167 medication-naïve or minimally treated patients with first-episode schizophrenia, schizophreniform disorder, or schizoaffective disorder entering a three-phase trial, at seven sites. Patients in remission at the end of each phase were randomized to treatment as usual, with or without an adjunctive psycho-social intervention for medication adherence. The final follow-up visit was at 74 weeks. A total of 108 patients (70%) were in remission at Week 4, 85 (55%) at Week 22, and 97 (63%) at Week 74. We found no baseline regional differences in volumes, cortical thickness, surface area, or local gyrification between patients who did or did not achieved remission at any time point. However, patients not in remission at Week 74, at baseline showed reduced structural connectivity across frontal, anterior cingulate, and insular cortices. A similar pattern was evident in patients not in remission at Week 4 and Week 22, although not significantly. Lack of symptom remission in first-episode psychosis is not associated with regional brain alterations at illness onset. Instead, when the illness becomes a stable entity, its association with the altered organization of cortical gyrification becomes more defined.

AB - Individuals with psychoses have brain alterations, particularly in frontal and temporal cortices, that may be particularly prominent, already at illness onset, in those more likely to have poorer symptom remission following treatment with the first antipsychotic. The identification of strong neuroanatomical markers of symptom remission could thus facilitate stratification and individualized treatment of patients with schizophrenia. We used magnetic resonance imaging at baseline to examine brain regional and network correlates of subsequent symptomatic remission in 167 medication-naïve or minimally treated patients with first-episode schizophrenia, schizophreniform disorder, or schizoaffective disorder entering a three-phase trial, at seven sites. Patients in remission at the end of each phase were randomized to treatment as usual, with or without an adjunctive psycho-social intervention for medication adherence. The final follow-up visit was at 74 weeks. A total of 108 patients (70%) were in remission at Week 4, 85 (55%) at Week 22, and 97 (63%) at Week 74. We found no baseline regional differences in volumes, cortical thickness, surface area, or local gyrification between patients who did or did not achieved remission at any time point. However, patients not in remission at Week 74, at baseline showed reduced structural connectivity across frontal, anterior cingulate, and insular cortices. A similar pattern was evident in patients not in remission at Week 4 and Week 22, although not significantly. Lack of symptom remission in first-episode psychosis is not associated with regional brain alterations at illness onset. Instead, when the illness becomes a stable entity, its association with the altered organization of cortical gyrification becomes more defined.

KW - Schizophrenia

KW - MRI

KW - Gyrification

KW - Trial

KW - First episode

KW - Cortical thickness

KW - OPTiMiSE

UR - http://www.scopus.com/inward/record.url?scp=85103226491&partnerID=8YFLogxK

U2 - 10.1093/schbul/sbaa115

DO - 10.1093/schbul/sbaa115

M3 - Article

SN - 0586-7614

VL - 47

SP - 444

EP - 455

JO - Schizophrenia Bulletin

JF - Schizophrenia Bulletin

IS - 2

ER -

Symptom Remission and Brain Cortical Networks at First Clinical Presentation of Psychosis: The OPTiMiSE Study

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Keywords

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