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. 2023 May:255:246-255.
doi: 10.1016/j.schres.2023.03.027. Epub 2023 Apr 10.

Increased parietal and occipital lobe gyrification predicts conversion to syndromal psychosis in a clinical high-risk cohort

Rakshathi Basavaraju  1 , Jeanelle France  1 , Hannah C Sigmon  1 , Ragy R Girgis  2 , Gary Brucato  2 , Jeffrey A Lieberman  2 , Scott A Small  1 , Frank A Provenzano  3
Affiliations

Increased parietal and occipital lobe gyrification predicts conversion to syndromal psychosis in a clinical high-risk cohort

Rakshathi Basavaraju et al. Schizophr Res. 2023 May.

Abstract

Background: Local gyrification index (lGI), indicative of the degree of cortical folding is a proxy marker for early cortical neurodevelopmental abnormalities. We studied the difference in lGI between those who do and do not convert to psychosis (non-converters) in a clinical high-risk (CHR) cohort, and whether lGI predicts conversion to psychosis.

Methods: Seventy-two CHR participants with attenuated positive symptom syndrome were followed up for two years. The difference in baseline whole-brain lGI was examined on the T1-weighted MRIs between, i)CHR (N = 72) and healthy controls (N = 19), ii)Converters to psychosis (N = 24) and non-converters (N = 48), adjusting for age and sex, on Freesurfer-6.0. The significant cluster obtained in the converters versus non-converters comparison was registered as a region of interest to individual images of all 72 participants and lGI values were extracted from this region. A cox proportional hazards model was applied with these values to study whether lGI predicts conversion to psychosis.

Results: lGI was not different between CHR and healthy controls. lGI was increased in converters in the right-sided inferior parietal and lateral occipital areas (corrected cluster-wise-p-value = 0.009, cohen's f = 0.42) compared to non-converters, which significantly increased the risk of onset of psychosis (p = 0.029, hazard ratio = 1.471).

Conclusions: Increased gyrification in the right-sided inferior parietal and lateral occipital area differentiates converters to psychosis in CHR, significantly increasing the risk of conversion to psychosis. This measure may reflect underlying traits in parts of the brain that develop earliest in-utero (parietal and occipital), conferring a heightened vulnerability to convert to syndromal psychosis subsequently.

Keywords: Clinical high-risk (CHR); Inferior parietal; Lateral occipital; Local gyrification index (lGI); Neurodevelopmental; Psychosis.

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Conflict of interest statement

Declaration of competing interest FAP is an advisor for and has equity in Imij Technologies. RRG receives research funding from BioAdvantex Pharma, Genentech, and Allergan. SAS has equity in or serves on the scientific advisory board of Denali Therapeutics, MeiraGTx, and Imij Technologies. Both FAP and SAS have a patent related to generating cerebral blood volume from which no royalties are received. JAL receives grant and/or research support or serves on the advisory board of but receives no direct financial compensation or salary support from, Alkermes, Boehringer Ingelheim, Intra-Cellular Therapies, Eli Lilly and Company/Denovo Biopharma, Pierre Fabre, Taisho Pharmaceutical R&D, Inc., and Teva and has patent payments from Repligen and royalty payments from Little, Brown (Shrinks: The Untold Story of Psychiatry). GB receives royalty payments from Prometheus Books (The New Evil: Under- standing the Emergence of Modern Violent Crime). RB, JF and HCS report no biomedical financial interests or potential conflicts of interest.

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