Changes in distributed neural circuitry function in patients with first-episode schizophrenia

Background: A number of functional brain abnormalities have been reported in schizophrenia, but it remains to be determined which ofthem represent trait and state markers of the illness. Aims: To delineate regional brain dysfunctions that remain stable and those that fluctuate during the course of schizophrenia. Method: A cohort of patients with first-episode schizophrenia and a matched group of control participants underwent functional magnetic resonance imaging on two occasions 6-8 weeks apart during performance of a working memory task. The patients' disease was in partial remission at the second scan. Results: Relative to control participants, the function of the left dorsolateral prefrontal cortex, left thalamus and right cerebellum remained disturbed in the people with schizophrenia, whereas the dysfunction of the right dorsolateral prefrontal cortex, right thalamus, left cerebellum and cingulate gyrus normalised, with significant reduction in symptoms. Conclusions: These results suggest that dysfunction of the left fronto-thalamo-cerebellar circuitry is a relatively stable characteristic of schizophrenia, whereas disturbance of the right circuitry and cingulate gyrus is predominantly a state-related phenomenon.