The British Journal of Psychiatry (2008) 193: 210-215. doi: 10.1192/bjp.bp.107.043463
© 2008 The Royal College of Psychiatrists
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White matter volume changes in people who develop psychosis

Mark Walterfang, FRANZCP

Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Neuropsychiatry Unit, Royal Melbourne Hospital, and North Western Mental Health Program, Sunshine Hospital and Royal Melbourne Hospital, Melbourne

Philip K. McGuire, PhD, MRCPsych

Institute of Psychiatry, King’s College London, University of London, UK

Alison R. Yung, MD, FRANZCP

ORYGEN Research Centre, Early Psychosis Prevention and Intervention Centre (EPPIC), Personal Assistance and Crisis Evaluation (PACE) Clinic, and Department of Psychiatry, University of Melbourne, Melbourne

Lisa J. Phillips, PhD

Department of Psychology, University of Melbourne

Dennis Velakoulis, FRANZCP

Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Neuropsychiatry Unit, Royal Melbourne Hospital, and North Western Mental Health Program, Sunshine Hospital and Royal Melbourne Hospital, Melbourne

Stephen J. Wood, PhD

Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, and North Western Mental Health Program, Sunshine Hospital and Royal Melbourne Hospital, Melbourne

John Suckling, PhD

Brain Mapping Unit, Department of Psychiatry, University of Cambridge, Cambridge, UK

Edward T. Bullmore, PhD, MRCPsych

Brain Mapping Unit, Department of Psychiatry, University of Cambridge, Cambridge

Warrick Brewer, PhD

ORYGEN Research Centre, EPPIC, PACE Clinic, and Department of Psychiatry, Univeristy of Melbourne, Melbourne

Bridget Soulsby, BSc

Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, and North Western Mental Health Program, Sunshine Hospital and Royal Melbourne Hospital, Melbourne

Patricia Desmond, MSc, FRACR

Department of Radiology, Royal Melbourne Hospital, Melbourne

Patrick D. McGorry, PhD, FRANZCP

ORYGEN Research Centre, EPPIC, PACE Clinic, and Department of Psychiatry, University of Melbourne, Melbourne

Christos Pantelis, MD, MRCPsych, FRANZCP

Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, and North Western Mental Health Program, Sunshine Hospital and Royal Melbourne Hospital, Melbourne, Australia

Correspondence: Dr Mark Walterfang, Melbourne Neuropsychiatry Centre, Level 2, John Cade Building, Royal Melbourne Hospital, 3050 Australia. Email: mark.walterfang{at}mh.org.au

Declaration of interest

None.

Background

Grey matter changes have been described in individuals who are pre- and peri-psychotic, but it is unclear if these changes are accompanied by changes in white matter structures.

Aims

To determine whether changes in white matter occur prior to and with the transition to psychosis in individuals who are pre-psychotic who had previously demonstrated grey matter reductions in frontotemporal regions.

Method

We used magnetic resonance imaging (MRI) to examine regional white matter volume in 75 people with prodromal symptoms. A subset of the original group (n=21) were rescanned at 12–18 months to determine white matter volume changes. Participants were retrospectively categorised according to whether they had or had not developed psychosis at follow-up.

Results

Comparison of the baseline MRI data from these two subgroups revealed that individuals who later developed psychosis had larger volumes of white matter in the frontal lobe, particularly in the left hemisphere. Longitudinal comparison of data in individuals who developed psychosis revealed a reduction in white matter volume in the region of the left fronto-occipital fasciculus. Participants who had not developed psychosis showed no reductions in white matter volume but increases in a region subjacent to the right inferior parietal lobule.

Discussion

The reduction in volume of white matter near the left fronto-occipital fasciculus may reflect a change in this tract in association with the onset of frank psychosis.


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