Antipsychotics effects on network-level reconfiguration of cortical morphometry in first-episode schizophrenia

AbstractBackgroundCortical thickness reductions are evident in patients with schizophrenia. Associations between antipsychotic medications (APMs) and cortical morphometry have been explored in schizophrenia patients. This raises the question of whether the reconfiguration of morphological architecture by APM plays potential compensatory roles for abnormalities in the cerebral cortex.MethodsStructural MRI were obtained from 127 medication-naive first-episode schizophrenia (FES) patients and 133 matched healthy controls. Patients received 12 weeks of APM and were categorized as responders (n=75) or nonresponders (n=52) at follow-up. Using surface-based morphometry and structural covariance analysis, this study investigated the short-term effects of antipsychotics on cortical thickness and cortico-cortical connectivity. Global efficiency was computed to characterize network integration of the large-scale structural connectome. The relationship between connectivity and cortical thinning was examined by the structural covariance analysis among top-n regions with thickness reduction.ResultsWidespread cortical thickness reductions were observed in pre-APM patients. Post-APM patients showed more reductions in cortical thickness, even in the frontotemporal regions without baseline reductions. Covariance analysis revealed strong cortico-cortical connectivity and higher network integration in responders than in nonresponders. Notably, the nonresponders lacked key nodes of the prefrontal and temporal regions for the covariance network between top-n regions with cortical thickness reductions.ConclusionsAntipsychotic effects are not restricted to a single brain region but rather exhibit a network-level covariance pattern. Neuroimaging connectomics highlights the positive effects of antipsychotics on the reconfiguration of brain architecture, suggesting that abnormalities in regional morphology may be compensated by increasing interregional covariance when symptoms are controlled by antipsychotics.