Abnormal anterior cingulum integrity in first episode, early-onset schizophrenia: A diffusion tensor imaging study

Adolescents with early-onset schizophrenia (EOS) provide a unique opportunity to examine regional and disease-specific early abnormal brain development in schizophrenia. There is currently a general agreement that clinical symptoms and cognitive dysfunctions of schizophrenia may arise from a failure of adequate communication between different brain regions. This disturbed connectivity may be related to alterations in the numbers, distribution, and ultrastructural integrity of oligodendrocytes of white matter. Diffusion tensor imaging provides a relatively new approach for quantifying possible connectivity of white matter in vivo. In this study, thirty-eight adolescents with early-onset schizophrenia (EOS; onset of psychotic symptoms by age 18years) and 38 age- and gender-matched healthy volunteers received diffusion tensor imaging examinations. Fractional anisotropy images were compared between groups in the white matter using a voxelwise analysis after inter-subject registration to standard Montreal Neurological Institute (MNI) space. Adolescents with EOS demonstrated significantly reduced fractional anisotropy in right anterior cingulum compared to healthy volunteers. Increased fractional anisotropy was not observed in any brain region in patients compared to controls. ROI analysis also reported a trend-level negative correlation between mean regional FA in right anterior cingulum and PANSS positive symptom score. These findings indicate that white matter abnormalities in the anterior cingulum are associated with adolescent EOS.