Altered default network connectivity in FEP patients

By Mark Cowen

Patients with a first episode of psychosis (FEP) show altered functional connectivity in the dorsomedial prefrontal cortex (dMPFC) default network subsystem, researchers report.

The findings, published in Schizophrenia Research, reflect functional connectivity alterations previously observed in patients with chronic schizophrenia, suggesting that such abnormalities are present even in the early stages of psychosis.

Anna Alonso-Solís (Universitat Autònoma de Barcelona, Spain) and team compared functional connectivity in the default network in 19 FEP patients (14 men), aged a mean of 24.9 years, and 19 mentally healthy controls, aged an average of 26.1 years, using resting state functional magnetic resonance imaging (R-fMRI).

Analysis of the imaging data revealed that FEP patients exhibited a number of alterations in the dMPFC subsystem compared with controls.

Specifically, FEP patients had weaker positive functional connectivity between the dMPFC and the posterior cingulate cortex (PCC)/precuneus, and this reduction in connectivity extended toward the parietal lobe to the posterior angular gyrus.

FEP patients also showed weaker negative functional connectivity between the lateral temporal cortex and the intracalcarine cortex (medial occipital lobe), bilaterally.

Furthermore, FEP patients showed weaker negative functional connectivity between both the PCC and the temporo-parietal junction and the right fusiform gyrus, extending to the lingual gyrus and lateral occipital cortex (temporo-parietal junction) compared with controls.

By contrast, FEP patients showed stronger negative functional connectivity between the temporal pole and the medial motor cortex, anterior precuneus, and posterior mid-cingulate cortex than controls.

Alonso-Solís and team conclude: "Future R-fMRI prospective studies comparing patients who develop schizophrenia to patients who do not will be expected to advance our understanding of the pathophysiology of schizophrenia in the service of developing personalized therapeutic approaches targeting the early stages of the psychotic process."

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