Basic symptoms and gray matter volumes of patients at clinical high risk for psychosis

Hubl, Daniela; Michel, Chantal; Schultze-Lutter, Frauke; Hauf, Martinus; Schimmelmann, Benno G.; Kaess, Michael; Kindler, Jochen (2021). Basic symptoms and gray matter volumes of patients at clinical high risk for psychosis. Psychological medicine, 51(15), pp. 2666-2674. Cambridge University Press 10.1017/S0033291720001282

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Background. Clinical high-risk (CHR) for psychosis is indicated by ultra-high risk (UHR)
and basic symptom (BS) criteria; however, conversion rates are highest when both UHR
and BS criteria are fulfilled (UHR&BS). While BSs are considered the most immediate expression
of neurobiological aberrations underlying the development of psychosis, research on
neurobiological correlates of BS is scarce.
Methods. We investigated gray matter volumes (GMV) of 20 regions of interest (ROI)
previously associated with UHR criteria in 90 patients from the Bern early detection service:
clinical controls (CC), first-episode psychosis (FEP), UHR, BS and UHR&BS. We expected
lowest GMV in FEP and UHR&BS, and highest volume in CC with UHR and BS in-between.
Results. Significantly, lower GMV was detected in FEP and UHR&BS patients relative to CC
with no other significant between-group differences. When ROIs were analyzed separately,
seven showed a significant group effect (FDR corrected), with five (inferior parietal, medial
orbitofrontal, lateral occipital, middle temporal, precuneus) showing significantly lower GM
volume in the FEP and/or UHR&BS groups than in the CC group (Bonferroni corrected).
In the CHR group, only COGDIS scores correlated negatively with cortical volumes.
Conclusions. This is the first study to demonstrate that patients who fulfill both UHR and BS
criteria – a population that has been associated with higher conversion rates – exhibit more
severe GMV reductions relative to those who satisfy BS or UHR criteria alone. This result
was mediated by the BS in the UHR&BS group, as only the severity of BS was linked to
GMV reductions.

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