Background: Duration of untreated psychosis (DUP) has been shown to be associated with both poor short-term and long-term outcomes in schizophrenia. Even so, few studies have used functional neuroimaging to investigate DUP in schizophrenia. In the present study, we used near-infrared spectroscopy (NIRS) to investigate the influence of DUP on brain functions during a verbal fluency test (VFT) in patients with schizophrenia.
Methods: A total of 62 patients with schizophrenia were included. They were categorized into either short treatment (≤6months, n=33) or long treatment (>6months, n=29) groups based on their duration of treatment. Hemodynamic changes over the frontotemporal regions during a VFT were measured using multi-channel NIRS. We examined the associations between DUP and hemodynamic changes in each group to explore if there were different effects of DUP on brain cortical activity at different treatment durations.
Results: In the long treatment group, we found significant associations between a longer DUP and decreased cortical activity approximately at the left inferior frontal gyrus, left middle frontal gyrus, left postcentral gyrus, right precentral gyrus, bilateral superior temporal gyrus, and bilateral middle temporal gyrus, whereas no associations between DUP and brain cortical activity were observed in the short treatment group.
Conclusions: Our results indicated that longer DUP may be associated with decreased level of cortical activities over the frontotemporal regions in the long-term. Early detection and intervention of psychosis that shortens DUP might help to improve the long-term outcomes in patients with schizophrenia.
Keywords: DOI; DOT; DUP; Duration of untreated psychosis (DUP); FDR; FEP; GAF; IFG; IQ; LONI probabilistic brain atlas; LPBA; MFG; MRI; MRS; MTG; NIRS; Near-Infrared Spectroscopy (NIRS); PANSS; PET; SPECT; STG; Schizophrenia; VFT; Verbal fluency test (VFT); duration of illness; duration of treatment; duration of untreated psychosis; fMRI; false discovery rate; first episode psychosis; functional magnetic resonance image; global assessment of functioning scale; inferior frontal gyrus; intelligence quotient; magnetic resonance imaging; magnetic resonance spectroscopy; middle frontal gyrus; middle temporal gyrus; near-infrared spectroscopy; positron emission tomography; single-photon emission computed tomography; superior temporal gyrus; the positive and negative syndrome scale; verbal fluency test.
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