White matter integrity in individuals at ultra-high risk for psychosis: A systematic review and discussion of the role of polyunsaturated fatty acids

N Vijayakumar; C Bartholomeusz; T Whitford; Daniel F Hermens; B Nelson; S Rice; S Whittle; C Pantelis; P McGorry; M R Schäfer; G P Amminger

doi:10.1186/s12888-016-0932-4

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White matter integrity in individuals at ultra-high risk for psychosis: A systematic review and discussion of the role of polyunsaturated fatty acids

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White matter integrity in individuals at ultra-high risk for psychosis: A systematic review and discussion of the role of polyunsaturated fatty acids

N Vijayakumar, C Bartholomeusz, T Whitford, Daniel F Hermens, B Nelson, S Rice, S Whittle, C Pantelis, P McGorry, M R Schäfer, …

BMC Psychiatry, Vol.16(1), 287

2016

DOI: https://doi.org/10.1186/s12888-016-0932-4

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Abstract

ultra-high risk

psychosis

white matter

polyunsaturated fatty acids

youth

Background: Schizophrenia is thought to be a neurodevelopmental disorder with pathophysiological processes beginning in the brain prior to the emergence of clinical symptoms. Recent evidence from neuroimaging studies using techniques such as diffusion tensor imaging has identified white matter abnormalities that are suggestive of disrupted brain myelination and neuronal connectivity. Identifying whether such effects exist in individuals at high risk for developing psychosis may help with prevention and early intervention strategies. In addition, there is preliminary evidence for a role of lipid biology in the onset of psychosis, along with well-established evidence of its role in myelination of white matter tracts. As such, this article synthesises the literature on polyunsaturated fatty acids (PUFAs) in myelination and schizophrenia, hypothesizing that white matter abnormalities may potentially mediate the relationship between PUFAs and schizophrenia. Methods: Diffusion tensor imaging studies were identified through a systematic search of existing literature. Studies examined white matter integrity in ultra-high risk (UHR) samples, as assessed using structured diagnostic interviews. Data was extracted and summarised as a narrative review. Results: Twelve studies met inclusion criteria, and findings identified reduced fractional anisotropy and higher diffusivity. Although the exact location of abnormalities remains uncertain, fronto-temporal and fronto-limbic connections, including the superior longitudinal and uncinate fasiculus, cingulum, and corpus callosum appear to be implicated. Because of preliminary evidence suggesting lipid biology may be relevant for the onset of psychosis, a discussion is provided of the role of polyunsaturated fatty acids (PUFAs) in myelination and risk for psychosis. Conclusions: While the function of PUFAs in myelination is well-established, there is growing evidence of reduced PUFA concentration in UHR samples, highlighting the need for research to examine the relationship between PUFA and white matter integrity in high-risk samples and age-matched healthy controls. Such investigations will help to better understand the pathophysiology of the disorder, and potentially assist in the development of novel treatment and early intervention strategies. © 2016 The Author(s).

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Title: White matter integrity in individuals at ultra-high risk for psychosis: A systematic review and discussion of the role of polyunsaturated fatty acids
Authors: N Vijayakumar (Author) - University of Melbourne
C Bartholomeusz (Author) - University of Melbourne
T Whitford (Author) - University of Sydney
Daniel F Hermens (Author) - University of New South Wales
B Nelson (Author) - University of Melbourne
S Rice (Author) - University of Melbourne
S Whittle (Author) - University of Melbourne
C Pantelis (Author) - University of Melbourne
P McGorry (Author) - University of Melbourne
M R Schäfer (Author) - University of Melbourne
G P Amminger (Author) - University of Melbourne
Publication details: BMC Psychiatry, Vol.16(1), 287
Publisher: BioMed Central Ltd.
Date published: 2016
DOI: 10.1186/s12888-016-0932-4
ISSN: 1471-244X
Copyright note: Copyright © 2016 The Author(s). Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Organisation Unit: University of the Sunshine Coast, Queensland; Thompson Institute
Language: English
Record Identifier: 99450608102621
Output Type: Journal article

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