Abstract
Recent work has clearly established that early persistent negative symptoms (ePNS) can be observed following a first episode of psychosis (FEP), and can negatively affect functional outcome. There is also evidence for cortical changes associated with ePNS. Given that a FEP often occurs during a period of ongoing complex brain development and maturation, neuroanatomical changes may have a specific age-related component. The current study examines cortical thickness (CT) and trajectories with age using longitudinal structural imaging. Structural T1 volumes were acquired at three time points for ePNS (N=21), PNS due to secondary factors (N=31), non-PNS (N=45) patients, and controls (N=48). Images were processed using the CIVET pipeline. Linear mixed models were applied to test for the main effects of (a) group, (b) time, and interactions between (c) time and group membership, and (d) age and group membership. Compared with the non-PNS and secondary PNS patient groups, the ePNS group showed cortical thinning over time in temporal regions and a thickening with age primarily in prefrontal areas. Early PNS patients also had significantly different linear and quadratic age relationships with CT compared with other groups within cingulate, prefrontal, and temporal cortices. The current study demonstrates that FEP patients with ePNS show significantly different CT trajectories with age. Increased CT may be indicative of disruptions in cortical maturation processes within higher-order brain regions. Individuals with ePNS underline a unique subgroup of FEP patients that are differentiated at the clinical level and who exhibit distinct neurobiological patterns compared with their non-PNS peers.
Highlights
The first episode of psychosis (FEP) marks a critical turning point in the lives of affected youth and is manifested by varying combinations of symptoms at different levels of severity
The current study examined structural neuroanatomical patterns in clinically well-characterized FEP patients with Early persistent negative symptoms (ePNS) between the ages of 18 and 35
Significant differences in cortical thickness (CT) were found at the group level, across a FUP2 period, and longitudinally as a function of age, compared with other non-ePNS patients and controls
Summary
The first episode of psychosis (FEP) marks a critical turning point in the lives of affected youth and is manifested by varying combinations of symptoms at different levels of severity. Persistent negative symptoms (ePNS) following a FEP are of particular interest due to their high correlation with poor functional outcome,[1,2] including low clinical insight and deteriorating premorbid adjustment.[3] ePNS has been seldom studied due to a wider focus granted to the emergence of later negative symptoms, especially in the course of schizophrenia. The principal focus of this study will rest on the extraction of early PNS in a wellcharacterized clinical sample of FEP patients, including both affective and non-affective diagnoses
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