MTR abnormalities in subjects at ultra-high risk for schizophrenia and first-episode schizophrenic patients compared to healthy controls

Background: Neuroimaging studies have suggested gray (GM) and white matter (WM) abnormalities in early stages of schizophrenia. We aimed at evaluating subtle parenchymal alterations in individuals at ultra-high risk (UHR) for transition into psychosis and first-episode schizophrenic (FES) patients by measuring the magnetization transfer ratio (MTR). Methods and material In a cross-sectional study magnetization transfer images and high-resolution volumetric T1-weighted images were acquired in 70 age-and gender-matched subjects (25 UHR subjects, 16 FES patients and 29 controls) in a 1.5 Tesla scanner. Following normalization of MTR-maps the intensity histograms were analyzed by performing a Kruskal-Wallis-test. Results: Gray matter MTR decreases were depicted in UHR subjects solely, involving the cingulate gyrus and precentral cortex. WM MTR alterations were more pronounced in FES than in UHR patients and exclusively affected the frontal lobe bilaterally. In addition, UHR subjects showed bilateral MTR decreases at the stria terminalis though statistically significant only on the left side (p=0.018.) Conclusion: Our results indicate GM affection earlier on during disease progression as well as cumulative WM affection within frontal lobes during transition from UHR to FES. MTR reductions at the stria terminalis of UHR patients points to the involvement of the extended amygdala in the prodromal disease stage. (C) 2012 Elsevier B.V. All rights reserved.