Elsevier

Biological Psychiatry

Volume 82, Issue 10, 15 November 2017, Pages 737-745
Biological Psychiatry

Archival Report
Increased Occipital Gyrification and Development of Psychotic Disorders in Individuals With an At-Risk Mental State: A Multicenter Study

https://doi.org/10.1016/j.biopsych.2017.05.018Get rights and content

Abstract

Background

Anomalies of brain gyrification have been reported in schizophrenia, possibly reflecting its neurodevelopmental pathology. However, it remains elusive whether individuals at risk for psychotic disorders exhibit deviated gyrification patterns, and whether such findings, if present, are predictive of transition to psychotic disorders.

Methods

This multicenter magnetic resonance imaging study investigated brain gyrification and its relationship to later transition to psychotic disorders in a large sample of at-risk mental state (ARMS) individuals. T1-weighted magnetic resonance imaging scans were obtained from 104 ARMS individuals, of whom 21 (20.2%) exhibited the transition to psychotic disorders during clinical follow-up (mean = 4.9 years, SD = 2.6 years), and 104 healthy control subjects at 4 different sites. The local gyrification index (LGI) of the entire cortex was compared across the groups using FreeSurfer software.

Results

Compared with the control subjects, ARMS individuals showed a significantly higher LGI in widespread cortical areas, including the bilateral frontal, temporal, parietal, and occipital regions, which was partly associated with prodromal symptomatology. ARMS individuals who exhibited the transition to psychotic disorders showed a significantly higher LGI in the left occipital region compared with individuals without transition.

Conclusions

These findings suggested that increased LGI in diverse cortical regions might represent vulnerability to psychopathology, while increased LGI in the left occipital cortex might be related to subsequent manifestation of florid psychotic disorders as a possible surrogate marker.

Section snippets

Participants

One hundred four individuals with ARMS were recruited from domestic specialized clinical services for ARMS at Toyama University Hospital, The University of Tokyo Hospital, Toho University Hospital, and Tohoku University Hospital 30, 31. Each individual fulfilled the criteria of ARMS according to the Comprehensive Assessment of At-Risk Mental States (CAARMS) (32) (Toyama and Tohoku) or the Structured Interview for Prodromal Symptoms/the Scale of Prodromal Symptoms (SIPS/SOPS) (33) (Tokyo and

Demographic Background

There were no group differences in age and gender, but the healthy control subjects had attained a higher level of education compared with ARMS-T (p < .001), ARMS-NT (p < .001), and those individuals with unknown outcome because of dropout within 2 years (p < .001) (Table 1) groups. The ARMS-T and ARMS-NT individuals did not differ in their symptom severity on the basis of CAARMS scores and the medication dose (Table 1).

Group Comparison of LGI Between the ARMS and Control Subjects

Compared with the healthy control subjects, the ARMS individuals as a whole

Discussion

To the best of our knowledge, this is the first MRI study to examine the gyrification pattern of the entire cortex among individuals with clinical high risk for psychotic disorders using vertexwise analysis of the LGI. The present study analyzed the multicenter structural MRI dataset of high-risk individuals from Eastern Asia where the prevalence of cannabis use is particularly low, which could be a notable advantage for research of psychotic disorders by minimizing the possible confounding

Acknowledgments and Disclosures

This work was supported by Kiban C Grant No. 26461738 (to YT), Kiban C Grant No. 26461739 (to TT), and Kiban B Grant No. 24390281 (to MS) from the Japanese Society for the Promotion of Science; Health and Labour Sciences Research Grants for Comprehensive Research on Persons with Disabilities from the Japan Agency for Medical Research and Development (to MS, KM, and MM); the SENSHIN Medical Research Foundation (to YT); JSPS KAKENHI Grant Nos. JP16H06395, 16H06399, 16K21720, and 16H06280

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