Altered resting-state functional connectivity of the insula in individuals with clinical high-risk and patients with first-episode schizophrenia.

OBJECTIVES: Abnormalities in insular functional connectivity have been implicated in many clinical features of schizophrenia. The aim of this study was to determine to what degree such abnormalities occur in individuals with clinical high risk for psychosis (CHR), and whether which is associated with symptom severity. METHODS: Resting-state fMRI data were collected from 47 healthy controls, 24 CHR individuals and 19 patients with first-episode schizophrenia. Using the posterior, dorsal and ventral insular subregions as separate seeds, we examined resting-state functional connectivity differences between different groups and the association between concurrent symptom severity and dysconnectivity. RESULTS: Compared with healthy controls, both CHR individuals and schizophrenia patients showed hypoconnectivity between posterior insula (PI) and somatosensory areas, and between dorsal anterior insula (dAI) and putamen. Schizophrenia patients also showed dAI and ventral anterior insula(vAI) hyperconnectivity with visual areas relative to controls and CHR individuals. Correlation analysis revealed that dAI functional connectivity with superior temporal gyrus was positively correlated with positive symptoms of CHR, and vAI connectivity with dorsolateral prefrontal cortex was negatively correlated with the severity of the symptoms of first-episode schizophrenia. CONCLUSIONS: Our findings suggest that insular functional dysconnectivity with the sensory cortex may be a system-level neural substrate preceding the onset of psychosis.

Network functional connectivity analysis in individuals at ultrahigh risk for psychosis and patients with schizophrenia.

Schizophrenia is a severe mental disorder, and the onset of which is preceded by a stage of ultrahigh risk (UHR) for developing psychosis. Therefore, analyzing individuals with UHR is essential for identifying predictive biomarkers for the onset of schizophrenia. The current study aimed to identify such biomarkers based on a voxelwise whole-brain functional degree centrality (FDC) analysis. Conjunction analysis showed that, compared with healthy controls, both UHR subjects and patients with schizophrenia showed significantly increased FDC at the medial prefrontal cortex (MPFC) and significantly decreased FDC at the right fusiform gyrus (FG). The subsequent partial correlation analysis showed significant correlations between the disorganization symptoms and FDCs at the MPFC and the right FG for both UHR subjects and patients with schizophrenia. These findings suggest that FDC within the MPFC and the right FG could be candidate biomarkers for the onset of schizophrenia.