Exploring white matter microstructure and the impact of antipsychotics in adolescent-onset psychosis

PLoS One. 2020 May 29;15(5):e0233684. doi: 10.1371/journal.pone.0233684. eCollection 2020.

Abstract

White matter abnormalities are well-established in adult patients with psychosis. Less is known about abnormalities in the rarely occurring adolescent early onset psychosis (EOP). In particular, whether antipsychotic medication might impact white matter microstructure is not known. Using 3T diffusion weighted imaging, we investigated differences in white matter microstructure and the impact of antipsychotic medication status in medicated (n = 11) and unmedicated (n = 11) EOP patients relative to healthy controls (n = 33), aged between 12-18 years. Using Tract-based Spatial Statistics, we calculate case-control differences in scalar diffusion measures, i.e. fractional anisotropy (FA), axial diffusion (AD) and radial diffusion (RD), and investigated their association with antipsychotic medication in patients. We found significantly lower FA in the left genu of the corpus callosum, the left anterior corona radiata (ACR) and the right superior longitudinal fasciculus in EOP patients relative to healthy controls. AD values were also lower in the left ACR, largely overlapping with the FA findings. Mean FA in the left ACR was significantly associated with antipsychotic medication status (Cohen's d = 1.37, 95% CI [0.01, 2.68], p = 0.008), showing higher FA values in medicated compared to unmedicated EOP patients. The present study is the first to link antipsychotic medication status to altered regional FA in the left ACR, a region hypothesized to contribute to the etiology of psychosis. Replications are warranted to draw firm conclusions about putatively enhancing effects of antipsychotic medication on white matter microstructure in adolescent-onset psychosis.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Anisotropy
  • Antipsychotic Agents / administration & dosage*
  • Child
  • Diffusion Tensor Imaging*
  • Female
  • Humans
  • Male
  • Psychotic Disorders / diagnostic imaging*
  • Psychotic Disorders / drug therapy*
  • White Matter / diagnostic imaging*

Substances

  • Antipsychotic Agents

Grants and funding

This work was supported by the Research Council of Norway, grant numbers 223273, 213700, and 250358 (awarded to IA); the South-Eastern Norway Regional Health Authority, grant numbers 2016-118 and 2017-097 (awarded to IA); and Kristian Gerhard Jebsen Centre for Psychosis Research (SKGJ-MED-008, awarded to NORMENT). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.