Abstract
Delusional thinking is one of the hallmark symptoms of schizophrenia. However, the underlying neural substrate for delusions in schizophrenia remains unknown. In an attempt to further our understanding of the neural basis of delusions, we explored gray matter deficits and their clinical associations in first-episode schizophrenia patients with and without delusions. Twenty-four first-episode schizophrenia patients with delusions and 18 without delusions as well as 26 healthy controls (HC) underwent clinical assessment and whole-brain structural imaging which were acquired a 3.0 T scanner. Voxel-based morphometry was used to explore inter-group differences in gray matter volume using analysis of covariance, and Spearman correlation coefficients (rho) between the Scale for the Assessment of Positive Symptoms (SAPS)-delusion scores and mean regional brain volumes was obtained. Patients with delusions showed decreased brain gray matter volumes in the left putamen, thalamus, and caudate regions compared with HC. Patients with delusions also showed decreased regional volume in the left putamen and thalamus compared with patients without delusions. SAPS-delusion scores were negatively correlated with the gray matter volumes of the left putamen and thalamus. Left putamen and thalamus volume loss may be biological correlates of delusions in schizophrenia.
Highlights
In the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5), delusion is described as a false belief based on inferences about external reality that is firmly sustained in the mind despite the inconvertible and obvious proof to the contrary [1]
To minimize the impacts of illness duration and medication on patients, this study focused on a unique sample of schizophrenic patients who were experiencing their first episode and were drug naïve or having used antipsychotics for less than 8 weeks prior to scanning
One participant withdrew due to phobia of magnetic resonance imaging (MRI) machines
Summary
In the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5), delusion is described as a false belief based on inferences about external reality that is firmly sustained in the mind despite the inconvertible and obvious proof to the contrary [1]. As one of the most prominent symptoms of schizophrenia, delusion carries significant clinical value. There are many types of delusions in. Gray Matter Correlates with Delusions schizophrenia, including delusion of control, delusion of jealousy, delusion of reference, delusion of thought insertion and thought broadcasting, persecutory delusion, religious delusion, delusion of guilt, and somatic delusions [2]. Identifying the neural substrate of delusion would provide an important insight into the mechanism of schizophrenia, a highly heterogeneous disease [4]. Delusional thinking is one of the hallmark symptoms of schizophrenia. The underlying neural substrate for delusions in schizophrenia remains unknown. In an attempt to further our understanding of the neural basis of delusions, we explored gray matter deficits and their clinical associations in first-episode schizophrenia patients with and without delusions
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