Abstract

Diffusion tensor imaging (DTI) studies have provided evidence of widespread white matter (WM) abnormalities in schizophrenia. Although these abnormalities appear clinically significant, the relationship to specific clinical symptoms is limited and heterogeneous. This study examined the association between WM microstructure and the severity of the five main DSM-5 schizophrenia symptom dimensions. DTI was measured in forty patients with schizophrenia spectrum disorders. Using Tract-Based Spatial Statistics controlling for age, gender and antipsychotic dosage, our analyses revealed significant negative relationships between WM microstructure and two DSM-5 symptom dimensions: Whereas abnormal psychomotor behavior was particularly related to WM of motor tracts, negative symptoms were associated with WM microstructure of the prefrontal and right temporal lobes. However, we found no associations between WM microstructure and delusions, hallucinations or disorganized speech. These data highlight the relevance of characteristic WM disconnectivity patterns as markers for negative symptoms and abnormal psychomotor behavior in schizophrenia and provide evidence for relevant associations between brain structure and aberrant behavior.

Highlights

  • Schizophrenia is characterized by heterogeneous symptom patterns

  • In two out of five dimensions, i.e. abnormal psychomotor behavior and negative symptoms, the severity of symptoms was associated with white matter (WM) brain structure

  • fractional anisotropy (FA) differences between schizophrenia patients and matched controls are given in the supplemental material

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Summary

Introduction

Schizophrenia is characterized by heterogeneous symptom patterns. This heterogeneity has long been explained in terms of clinical subtypes, as in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (Tandon et al, 2013). Because these subtypes lack stability and biological correlates, they were eliminated and replaced by psychopathological dimensions in the DSM-5 (Barch et al, 2013; Peralta and Cuesta, 2001). Diffusion tensor imaging (DTI) is a non-invasive Magnetic Resonance Imaging (MRI)

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