Distinct Effects of Duration of Untreated Psychosis on Brain Cortical Activities in Different Treatment Phases of Schizophrenia: A Multi-Channel Near-Infrared Spectroscopy Study.

Department of Psychiatry, Taichung Veterans General Hospital, Taichung City, 40705, Taiwan.
Progress in Neuro-Psychopharmacology and Biological Psychiatry (Impact Factor: 3.69). 11/2013; 49. DOI: 10.1016/j.pnpbp.2013.11.009
Source: PubMed


Duration of untreated psychosis (DUP) has been shown to be associated with both poor short-term and long-term outcomes in schizophrenia. Even so, few studies have used functional neuroimaging to investigate DUP in schizophrenia. In the present study, we used near-infrared spectroscopy (NIRS) to investigate the influence of DUP on brain functions during a verbal fluency test (VFT) in patients with schizophrenia.
A total of 62 patients with schizophrenia were included. They were categorized into either short treatment (<6months, n=33) or long treatment (>6months, n=29) groups based on their duration of treatment. Hemodynamic changes over the frontotemporal regions during a VFT were measured using multi-channel NIRS. We examined the associations between DUP and hemodynamic changes in each group to explore if there were different effects of DUP on brain cortical activity at different treatment durations.
In the long treatment group, we found significant associations between a longer DUP and decreased cortical activity approximately at the left inferior frontal gyrus, left middle frontal gyrus, left postcentral gyrus, right precentral gyrus, bilateral superior temporal gyrus, and bilateral middle temporal gyrus, whereas no associations between DUP and brain cortical activity were observed in the short treatment group.
Our results indicated that longer DUP may be associated with decreased level of cortical activities over the frontotemporal regions in the long-term. Early detection and intervention of psychosis that shortens DUP might help to improve the long-term outcomes in patients with schizophrenia.

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    ABSTRACT: Near-infrared spectroscopy (NIRS) has been applied to examine the possible functional alternations during the performance of cognitive tasks in schizophrenia. With this technique, previous studies have observed that patients with schizophrenia are often associated with reduced brain activations in the prefrontal cortex during the verbal fluency task (VFT) of English version or Japanese version. However, it remains unclear whether there are the brain functional impairment for Chinese-speaking patients with schizophrenia. In this study, we designed a Chinese version VFT and performed a multichannel NIRS study in a large group of patients with schizophrenia and healthy controls. We investigated the brain activations during the task period of the Chinese version VFT within schizophrenia group and healthy group, respectively, and compared their relative changes between two groups. Our results confirmed that Chinese-speaking patients with schizophrenia had the significant lower brain activations in the prefrontal cortex and superior temporal cortex when compared with healthy controls. Such findings based on NIRS data provided us the reliable evidences about the brain functional deficits in Chinese-speaking patients with schizophrenia. Copyright © 2014. Published by Elsevier Inc.
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