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Multicenter Study
. 2021 Jan;51(2):340-350.
doi: 10.1017/S0033291719003568. Epub 2019 Dec 20.

Neuroanatomical abnormalities in first-episode psychosis across independent samples: a multi-centre mega-analysis

Sandra Vieira  1 , Qiyong Gong  2   3   4 , Cristina Scarpazza  1   5 , Su Lui  2   3   4 , Xiaoqi Huang  2   3   4 , Benedicto Crespo-Facorro  6   7 , Diana Tordesillas-Gutierrez  6   8 , Víctor Ortiz-García de la Foz  6   7 , Esther Setien-Suero  6   7 , Floor Scheepers  9 , Neeltje E M van Haren  9 , René Kahn  9 , Tiago Reis Marques  1 , Simone Ciufolini  1 , Marta Di Forti  10 , Robin M Murray  1 , Anthony David  11 , Paola Dazzan  1 , Philip McGuire  1 , Andrea Mechelli  1
Affiliations
Multicenter Study

Neuroanatomical abnormalities in first-episode psychosis across independent samples: a multi-centre mega-analysis

Sandra Vieira et al. Psychol Med. 2021 Jan.

Abstract

Background: Neuroanatomical abnormalities in first-episode psychosis (FEP) tend to be subtle and widespread. The vast majority of previous studies have used small samples, and therefore may have been underpowered. In addition, most studies have examined participants at a single research site, and therefore the results may be specific to the local sample investigated. Consequently, the findings reported in the existing literature are highly heterogeneous. This study aimed to overcome these issues by testing for neuroanatomical abnormalities in individuals with FEP that are expressed consistently across several independent samples.

Methods: Structural Magnetic Resonance Imaging data were acquired from a total of 572 FEP and 502 age and gender comparable healthy controls at five sites. Voxel-based morphometry was used to investigate differences in grey matter volume (GMV) between the two groups. Statistical inferences were made at p < 0.05 after family-wise error correction for multiple comparisons.

Results: FEP showed a widespread pattern of decreased GMV in fronto-temporal, insular and occipital regions bilaterally; these decreases were not dependent on anti-psychotic medication. The region with the most pronounced decrease - gyrus rectus - was negatively correlated with the severity of positive and negative symptoms.

Conclusions: This study identified a consistent pattern of fronto-temporal, insular and occipital abnormalities in five independent FEP samples; furthermore, the extent of these alterations is dependent on the severity of symptoms and duration of illness. This provides evidence for reliable neuroanatomical alternations in FEP, expressed above and beyond site-related differences in anti-psychotic medication, scanning parameters and recruitment criteria.

Keywords: First-episode psychosis; mega-analysis; multi-centre; neuroanatomy; voxel-based morphometry.

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Conflict of interest statement

None.

Figures

Fig. 1.
Fig. 1.
Inclusive masking procedure used to identify neuroanatomical abnormalities in FEP relative to HC consistent across all five sites. Left: an overall contrast with all FEP against all HC (p < 0.05 FWE corrected) was combined with five site-level contrasts (p < 0.05 uncorrected); this allowed us to identify only the voxels that survived both types of contrasts (intersection of all contrasts in black).
Fig. 2.
Fig. 2.
(a1) Regions showing statistically significant decreases in FEP relative to HC across the whole brain. (a2) Top Location of the gyrus rectus (straight gyrus) where the most pronounced GMV decrease was found; bottom: mean and standard deviation of the GMV in this region for each site. (b) Top Location of the right superior temporal gyrus (the only region showing statistically significant GMV increase in FEP relative to HC); bottom: mean and standard deviation of the GMV in this region for each site.
See this image and copyright information in PMC

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