The Relationship Between Grey Matter Volume and Clinical and Functional Outcomes in People at Clinical High Risk for Psychosis

Stefania Tognin; Anja Richter; Matthew J Kempton; Gemma Modinos; Mathilde Antoniades; Matilda Azis; Paul Allen; Matthijs G Bossong; Jesus Perez; Christos Pantelis; Barnaby Nelson; Paul Amminger; Anita Riecher-Rössler; Neus Barrantes-Vidal; Marie-Odile Krebs; Birte Glenthøj; Stephan Ruhrmann; Gabriele Sachs; Bart P F Rutten; Lieuwe de Haan; Mark van der Gaag; EU-GEI High Risk Study Group; Lucia R Valmaggia; Philip McGuire

doi:10.1093/schizbullopen/sgac040

The Relationship Between Grey Matter Volume and Clinical and Functional Outcomes in People at Clinical High Risk for Psychosis

Schizophr Bull Open. 2022 Jun 20;3(1):sgac040. doi: 10.1093/schizbullopen/sgac040. eCollection 2022 Jan.

Authors

Stefania Tognin¹, Anja Richter¹, Matthew J Kempton¹, Gemma Modinos¹, Mathilde Antoniades¹, Matilda Azis¹, Paul Allen¹, Matthijs G Bossong¹, Jesus Perez², Christos Pantelis³, Barnaby Nelson⁴, Paul Amminger⁴, Anita Riecher-Rössler⁵, Neus Barrantes-Vidal⁶, Marie-Odile Krebs⁷, Birte Glenthøj⁸, Stephan Ruhrmann⁹, Gabriele Sachs¹⁰, Bart P F Rutten¹¹, Lieuwe de Haan¹², Mark van der Gaag¹³; EU-GEI High Risk Study Group; Lucia R Valmaggia¹⁴, Philip McGuire¹

Collaborators

EU-GEI High Risk Study Group:
Philip McGuire, Lucia R Valmaggia, Maria Calem, Mathilde Antoniades, Sara Pisani, Gemma Modinos, Lieuwe de Haan, Mark van der Gaag, Eva Velthorst, Tamar C Kraan, Daniella S van Dam, Nadine Burger, Barnaby Nelson, Patrick McGorry, G Paul Amminger, Christos Pantelis, Athena Politis, Joanne Goodall, Anita Riecher-Rössler, Stefan Borgwardt, Erich Studerus, Rodrigo Bressan, Ary Gadelha, Elisa Brietzke, Graccielle Asevedo, Elson Asevedo, Andre Zugman, Neus Barrantes-Vidal, Tecelli Domínguez-Martínez, Anna Racciopi, Thomas R Kwapil, Manel Monsonet, Lídia Hinojosa, Mathilde Kazes, Claire Daban, Julie Bourgin, Olivier Gay, Célia Mam-Lam-Fook, Marie-Odile Krebs, Dorte Nordholm, Lasse Randers, Kristine Krakauer, Louise Glenthøj, Birte Glenthøj, Merete Nordentoft, Stephan Ruhrmann, Dominika Gebhard, Julia Arnhold, Joachim Klosterkötter, Gabriele Sachs, Iris Lasser, Bernadette Winklbaur, Harald Aschauer, Philippe A Delespaul, Bart P Rutten, Jim van Os

Affiliations

¹ Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.
² CAMEO Early Intervention in Psychosis Services, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK.
³ Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne & Melbourne Health, Carlton South, Victoria, Australia.
⁴ Orygen, Parkville, Victoria, Australia.
⁵ University of Basel, Faculty of Medicine, Basel, Switzerland.
⁶ Departament de Psicologia Clínica i de la Salut (Universitat Autònoma de Barcelona), Fundació Sanitària Sant Pere Claver (Spain), Center for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain.
⁷ University of Paris, GHU-Paris, Sainte-Anne, C'JAAD, Hospitalo-Universitaire department SHU, Inserm U1266, Institut de Psychiatrie (CNRS 3557), Paris, France.
⁸ Center for Neuropsychiatric Schizophrenia Research, CNSR, and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Services Capital Region of Denmark, Mental Health Center Glostrup, Glostrup, Denmark.
⁹ Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital University of Cologne, Cologne, Germany.
¹⁰ Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.
¹¹ Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands.
¹² Early Psychosis Department, Amsterdam UMC, Amsterdam, The Netherlands.
¹³ Department of Clinical Psychology and Amsterdam Public Mental Health Research Institute, Faculty of Behavioural and Movement Sciences, VU University, Amsterdam, The Netherlands.
¹⁴ Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.

Abstract

Objective: To examine the association between baseline alterations in grey matter volume (GMV) and clinical and functional outcomes in people at clinical high risk (CHR) for psychosis.

Methods: 265 CHR individuals and 92 healthy controls were recruited as part of a prospective multi-center study. After a baseline assessment using magnetic resonance imaging (MRI), participants were followed for at least two years to determine clinical and functional outcomes, including transition to psychosis (according to the Comprehensive Assessment of an At Risk Mental State, CAARMS), level of functioning (according to the Global Assessment of Functioning), and symptomatic remission (according to the CAARMS). GMV was measured in selected cortical and subcortical regions of interest (ROI) based on previous studies (ie orbitofrontal gyrus, cingulate gyrus, gyrus rectus, inferior temporal gyrus, parahippocampal gyrus, striatum, and hippocampus). Using voxel-based morphometry, we analysed the relationship between GMV and clinical and functional outcomes.

Results: Within the CHR sample, a poor functional outcome (GAF < 65) was associated with relatively lower GMV in the right striatum at baseline (P < .047 after Family Wise Error correction). There were no significant associations between baseline GMV and either subsequent remission or transition to psychosis.

Conclusions: In CHR individuals, lower striatal GMV was associated with a poor level of overall functioning at follow-up. This finding was not related to effects of antipsychotic or antidepressant medication. The failure to replicate previous associations between GMV and later psychosis onset, despite studying a relatively large sample, is consistent with the findings of recent large-scale multi-center studies.

Keywords: clinical high risk for psychosis; clinical outcomes; functioning; grey matter volume; remission; structural magnetic resonance imaging; transition to psychosis.

Abstract

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