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Published Online: 1 April 2010

White Matter Integrity and Cognitive Impairment in First-Episode Psychosis

Rocío Pérez-Iglesias, M.D., Ph.D., Diana Tordesillas-Gutiérrez, M.Sc., Philip K. McGuire, F.R.C.Psych., Ph.D., Gareth J. Barker, Ph.D., Roberto Roiz-Santiañez, M.Sc., Ignacio Mata, M.D., Ph.D., Enrique Marco de Lucas, M.D., Jose Manuel Rodríguez-Sánchez, Ph.D., Rosa Ayesa-Arriola, M.Psych., Jose L. Vazquez-Barquero, M.D., Ph.D., and Benedicto Crespo-Facorro, M.D., Ph.D.Authors Info & Affiliations
Publication: American Journal of Psychiatry
Volume 167, Number 4
https://doi.org/10.1176/appi.ajp.2009.09050716
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Abstract

Objective

Impaired cognitive function has been identified as a core feature of schizophrenia. However, a significant proportion of patients do not show any cognitive deficits. The aim of this study was to assess if there were differences in white matter integrity between patients with and without cognitive impairment.

Method

A diffusion tensor imaging study and neurocognitive assessment were conducted in 49 patients with first-episode psychosis and 41 healthy comparison subjects. Subjects were assessed using the Continuous Performance Test, the Grooved Pegboard Test, the Rey Auditory Verbal Learning Test, and the Trail Making Test Part B. For each test, the patient sample was subdivided according to performance, with those scoring more than one standard deviation below the normative mean categorized as impaired. For each cognitive domain, white matter fractional anisotropy in deficit and nondeficit subgroups was compared using a voxel-based analysis. A nonparametric statistical method, controlling for multiple comparisons, was applied.

Results

Impairment on the Trail Making Test Part B was associated with reduced fractional anisotropy in the right/left anterior thalamic radiation and inferior fronto-occipital fasciculus, forceps minor, and left superior and inferior longitudinal fasciculi. Patients exhibiting Grooved Pegboard Test impairment showed reduced fractional anisotropy in the forceps minor, inferior fronto-occipital fasciculus, anterior thalamic radiation, and corticospinal and corticopontine tracts. Impaired performance on the Rey Auditory Verbal Learning Test and Continuous Performance Test was not associated with significant differences in fractional anisotropy.

Conclusion

Deficits in executive and motor functioning in patients with first-episode psychosis are associated with reductions in white matter integrity in the major fasciculi that connect the frontal and temporal cortices as well as in pathways connecting cortical and subcortical regions. Their presence at the onset of illness, in minimally medicated patients, indicates that these findings are not attributable to effects of chronic illness or its treatment.

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Information & Authors

Information

Published In

Go to American Journal of Psychiatry
Go to American Journal of Psychiatry
American Journal of Psychiatry
Volume 167 • Number 4 • April 2010
Pages: 451 - 458
PubMed: 20160006

History

Received: 22 May 2009
Accepted: 16 November 2009
Published online: 1 April 2010
Published in print: April 2010

Authors

Affiliations

Rocío Pérez-Iglesias, M.D., Ph.D.
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Diana Tordesillas-Gutiérrez, M.Sc.
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Philip K. McGuire, F.R.C.Psych., Ph.D.
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Gareth J. Barker, Ph.D.
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Roberto Roiz-Santiañez, M.Sc.
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Ignacio Mata, M.D., Ph.D.
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Enrique Marco de Lucas, M.D.
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Jose Manuel Rodríguez-Sánchez, Ph.D.
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Rosa Ayesa-Arriola, M.Psych.
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Jose L. Vazquez-Barquero, M.D., Ph.D.
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Benedicto Crespo-Facorro, M.D., Ph.D.
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Notes

Presented in part at the 15th annual meeting of the Organization for Human Brain Mapping, San Francisco, June 18–23, 2009. Received May 22, 2009; revisions received Sept. 16 and Nov. 6, 2009; accepted Nov. 16, 2009. From the Department of Psychiatry and Department of Radiology, Marqués de Valdecilla University Hospital and Marques de Valdecilla Research Institute (IFIMAV), University of Cantabria, Spain; Department of Clinical Neuroscience, Centre for Neuroimaging Sciences, and King's Health Partners, Institute of Psychiatry, King's College London; and CIBERSAM (Centro de Investigación Biomédica en Red en el área de Salud Mental). Address correspondence and reprint requests to Prof. Crespo-Facorro, Hospital Universitario Marqués de Valdecilla, Department of Psychiatry, Planta 2a, Edificio 2 de Noviembre. Avda. Valdecilla s/n, 39008, Santander, Spain; [email protected] (e-mail).

Competing Interests

Dr. Iglesias reports receiving support from Eli Lilly to attend conferences. Dr. McGuire reports receiving honoraria for lectures and consultancy fees from Eli Lilly, AstraZeneca, and Janssen Cilag. Dr. Barker reports receiving honoraria from General Electric (GE) for participating in advisory panel meetings and teaching GE programming courses. Dr. Mata reports receiving honoraria for lectures and support to attend conferences from Janssen Cilag. Dr. Vazquez-Bar­quero reports receiving unrestricted grant support from AstraZeneca, Pfizer, and Bristol-Myers Squibb. Dr. Crespo-Facorro reports receiving honoraria for his participation as a speaker at educational events from Bristol-Myers Squibb and Johnson & Johnson and consultant fees from Pfizer. He has received support to attend conferences from Johnson & Johnson. The remaining authors report no financial relationships with commercial interests.

Funding Information

Supported in part by grants from the Instituto de Salud Carlos III (FIS CP07/00008), Fundacio Seny, Fundación Marqués de Valdecilla.

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