White matter integrity and cortisol levels in relation to treatment response in first-episode psychosis

Presentation First Author: 
Tiago Reis Marques

Introduction: Previous studies have suggested that patients with first-episode of psychosis who show poor response to antipsychotic treatment have significantly impaired WM microstructure when compared to Responders. More recently, it as also been showed that baseline cortisol levels could also predict clinical outcome in first-episode psychosis. As the HPA axis is also known to indirectly affect white matter, is it possible to speculate that patient _s ability to respond to treatment is mediated through the effect of cortisol in white matter. Methods: DTI data were acquired in 63 first-episode psychosis patients. Response to treatment was assessed after 12-weeks and patients were classified as Responders or Non-Responders according to treatment outcome. We also collected salivary cortisol and diurnal cortisol levels and the cortisol awakening response were obtained. Tract-based spatial statistics (TBSS) was used to assess the relationship between cortisol levels, white matter integrity and treatment response. Results: The TBSS analysis revealed that lower cortisol awakening response at baseline was associated with lower WM integrity (FA) in the fornix and corpus callosum. Furthermore, our analysis also revealed that a significant association between FA and cortisol levels in relation to treatment response, suggesting a mediating effect of cortisol in white matter integrity. Discussion: To our knowledge, this is the first study to analyse the association between cortisol levels and white matter in relation to treatment response in first-episode psychosis. These findings suggest that cortisol could mediate response to treatment through it´s effect in the integrity of white matter.

Conference Name: 
Presentation Date: 
January, 2015
Additional Authors: 
Valeria Mondelli - Heather Taylor - Flavio DelAcqua - Simone Ciufolini - Marta Di Forti - Andy Simmons - Robin Murray - Carmine Pariante - Paola Dazzan
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