ArticleMolecular psychiatry2021
White matter integrity, duration of untreated psychosis, and antipsychotic treatment response in medication-naïve first-episode psychosis patients.
Article in Molecular psychiatry, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers.
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Who cites it
30 citing papers in PubMed.
- Higher-order functional brain networks and anterior cingulate glutamate + glutamine (Glx) in antipsychotic-naïve first episode psychosis patients.Translational psychiatry · 2024Trial
- Baseline symptom-related white matter tracts predict individualized treatment response to 12-week antipsychotic monotherapies in first-episode schizophrenia.Translational psychiatry · 2024Trial
- Cognitive subtypes and brain network differences in antipsychotic-naïve first-episode psychosis.Schizophrenia (Heidelberg, Germany) · 2026Article
- Duration of Untreated Psychosis, Treatment Response, and Resting State Functional Connectivity in Antipsychotic-Naïve First-Episode Psychosis Patients.Schizophrenia bulletin open · 2026Article
- Investigation of brain white matter and social cognition in schizophrenia and schizotypal personality disorder using neurite orientation dispersion and density imaging.Molecular psychiatry · 2025Article
- White Matter Integrity of the Three Subdivisions of the Superior Longitudinal Fasciculi in First-Episode Psychosis Patients.Psychiatry investigation · 2025Article
- Medications for psychosis in people with schizophrenia: what happens if you take them and what happens if you don't?CNS spectrums · 2025Review
- White matter microstructure alterations in early psychosis and schizophrenia.Translational psychiatry · 2025Article
- Stable White Matter Structure in the First Three Years After Psychosis Onset.Biological psychiatry global open science · 2025Article
- Decoding Early Psychoses: Unraveling Stable Microstructural Features Associated With Psychopathology Across Independent Cohorts.Biological psychiatry · 2025Article
- Higher-Order Intrinsic Brain Network Trajectories After Antipsychotic Treatment in Medication-Naïve Patients With First-Episode Psychosis.Biological psychiatry · 2024Article
- Correlation of Immune-Inflammatory Response System (IRS)/Compensatory Immune-Regulatory Reflex System (CIRS) with White Matter Integrity in First-Episode Patients with Schizophrenia.Molecular neurobiology · 2024Article
- Association of homocysteine with white matter dysconnectivity in schizophrenia.Schizophrenia (Heidelberg, Germany) · 2024Article
- Cortical Network Disruption Is Minimal in Early Stages of Psychosis.Schizophrenia bulletin open · 2024Article
- Longitudinal changes in brain metabolites in healthy controls and patients with first episode psychosis: a 7-Tesla MRS study.Molecular psychiatry · 2023Article
- Discovery of early schizophrenia through neuroimaging.Psychiatry research · 2023Article
- White matter microstructure in habit and reward circuits in anorexia nervosa: Insights from a neurite orientation dispersion and density imaging study.Acta psychiatrica Scandinavica · 2023Article
- Neurite Orientation Dispersion and Density Imaging in Psychiatric Disorders: A Systematic Literature Review and a Technical Note.Biological psychiatry global open science · 2023Review
- The neurobiology of duration of untreated psychosis: a comprehensive review.Molecular psychiatry · 2023Review
- Mapping Retinal Abnormalities in Psychosis: Meta-analytical Evidence for Focal Peripapillary and Macular Reductions.Schizophrenia bulletin · 2022Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
It is becoming increasingly clear that longer duration of untreated psychosis (DUP) is associated with adverse clinical outcomes in patients with psychosis spectrum disorders. Because this association is often cited when justifying early intervention efforts, it is imperative to better understand underlying biological mechanisms. We enrolled 66 antipsychotic-naïve first-episode psychosis (FEP) patients and 45 matched healthy controls in this trial. At baseline, we used a human connectome style diffusion-weighted imaging (DWI) sequence to quantify white matter integrity in both groups. Patients then received 16 weeks of treatment with risperidone, 51 FEP completed the trial. We compared whole-brain fractional anisotropy (FA), mean diffusivity, axial diffusivity (AD), and radial diffusivity between groups. To test if structural white matter integrity mediates the relationship between longer DUP and poorer treatment response, we fit a mediator model and estimated indirect effects. We found decreased whole-brain FA and AD in medication-naive FEP compared with controls. In patients, lower FA was correlated with longer DUP (r = -0.32; p = 0.03) and poorer subsequent response to antipsychotic treatment (r = 0.40; p = 0.01). Importantly, we found a significant mediation effect for FA (indirect effect: -2.70; p = 0.03), indicating that DUP exerts its effects on treatment response through affecting white matter integrity. Our data provide empirical support to the idea the DUP may have fundamental pathogenic effects on the natural history of psychosis, suggest a biological mechanism underlying this phenomenon, and underscore the importance of early intervention efforts in this disabling neuropsychiatric syndrome.
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