Neuroimaging predictors of functional outcomes in schizophrenia at baseline and 6-month follow-up.

TitleNeuroimaging predictors of functional outcomes in schizophrenia at baseline and 6-month follow-up.
Publication TypeJournal Article
Year of Publication2015
AuthorsBehdinan T, Foussias G, Wheeler AL, Stefanik L, Felsky D, Remington G, Rajji TK, Chakravarty MM, Voineskos AN
JournalSchizophr Res
Date Published2015 Dec
KeywordsAdult, Anisotropy, Brain, Diffusion Tensor Imaging, Female, Follow-Up Studies, Humans, Image Interpretation, Computer-Assisted, Linear Models, Male, Neural Pathways, Organ Size, Principal Component Analysis, Prognosis, Psychiatric Status Rating Scales, Schizophrenia, Schizophrenic Psychology, Treatment Outcome

PURPOSE: Studies show that deficit syndrome schizophrenia patients, characterized by primary negative symptoms and poor functional outcome, have impairment in specific neural circuits. We assessed whether these same neural circuits are directly linked to functional outcomes across schizophrenia patients.METHODS: T1- and diffusion-weighted MR images were obtained for schizophrenia (n=30) and matched healthy control participants (n=30). Negative symptoms and functional outcome were assessed at baseline and 6-month follow-up. Cortical thickness and tract-wise fractional anisotropy (FA) were compared between groups. To assess relationships of neuroimaging measures with functional outcome, principal component analysis (PCA) was performed on tract-wise FA values and components were entered into a multiple regression model for schizophrenia participants.RESULTS: Consistent with the literature, schizophrenia participants showed frontotemporal reductions in cortical thickness and tract-wise FA compared to controls. The top two components from PCA explained 71% of the variance in tract-wise FA values. The second component (associated with inferior longitudinal and arcuate fasciculus FA) was significantly correlated with functional outcome (baseline: β=0.54, p=0.03; follow-up: β=0.74, p=0.047); further analysis revealed this effect was mediated by negative symptoms. Post-hoc network analysis revealed increased cortical coupling between right inferior frontal and supramarginal gyri (connected by the arcuate fasciculus) in schizophrenia participants with poorer functional outcome.CONCLUSIONS: Our findings indicate that impairment in the same neural circuitry susceptible in deficit syndrome schizophrenia predicts functional outcome in a continuous manner in schizophrenia participants. This relationship was mediated by negative symptom burden. Our findings provide novel evidence for brain-based biomarkers of longitudinal functional outcome in people with schizophrenia.

Alternate JournalSchizophr. Res.
PubMed ID26603060
PubMed Central IDPMC4681643
Grant ListR01 MH102324 / MH / NIMH NIH HHS / United States
R01 MH099167 / MH / NIMH NIH HHS / United States
R01MH102324 / MH / NIMH NIH HHS / United States
R01MH099167 / MH / NIMH NIH HHS / United States
/ / Canadian Institutes of Health Research / Canada