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Patients with first-episode untreated schizophrenia who experience concomitant visual disturbances and auditory hallucinations exhibit co-impairment of the brain and retinas—a pilot study

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Abstract

There are limited structural brain and retina alteration data from schizophrenia patients who experience visual disturbances (VDs) with or without auditory hallucinations (AHs). We compared brain and retina alterations between first-episode untreated schizophrenia patients with VDs (FUSCH-VDs) with versus without AHs, and between patients and healthy controls (HCs)(N = 30/group). VDs, AHs, gray matter volumes (GMVs), and retinal thicknesses were evaluated with the Bonn Scale for Assessment of Basic Symptoms (BSABS) scale, the Auditory Hallucinations Rating Scale (AHRS), magnetic resonance imaging (MRI), and optical coherence tomography (OCT), respectively. Compared to HCs, FUSCH-VDs had reduced GMVs, mainly in dorsal V3/V3A and V5 regions, the fusiform gyrus, and ventral V4 and V8 regions. Most FUSCH-VDs (85.0%; 51/60) had primary visual cortex-retina co-impairments. FUSCH-VDs with AHs had more serious and larger scope GMV reductions than FUSCH-VDs without AHs. FUSCH-VDs with AHs had significant retinal thickness reductions compared to HCs. Primary visual cortex-retina co-impairments were found to be more common, and more pronounced when present, in FUSCH-VDs with AHs than in FUSCH-VDs without AHs. The present findings support the notion that VDs and AHs may have reciprocal deteriorating actions in patients with schizophrenia.

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Funding

This work was supported by grants from the National Natural Science Foundation of China (81,871,052 to C.Z., 81,801,679 and 81,571,319 to Y.X.), the Key Projects of the Natural Science Foundation of Tianjin, China (17JCZDJC35700 to C.Z.), the Tianjin Health Bureau Foundation (2014KR02 to C.Z.), the Zhejiang Public Welfare Fund Project (LGF18H090002 to D.J.), and the key project of Wenzhou Science and Technology Bureau (ZS2017011 to X.L.).

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Authors and Affiliations

  1. Department of Psychiatry, School of Mental Health, Jining Medical University, Jining, 272119, Shandong, China

    Chuanjun Zhuo & Feng Ji

  2. Psychiatric-Neuroimaging-Genetics Laboratory, Wenzhou Seventh People’s Hospital, Wenzhou, Zhejiang, 325000, China

    Chuanjun Zhuo, Xiaodong Lin, Deguo Jiang & Ce Chen

  3. Psychiatric-Neuroimaging-Genetics-Comorbidity Laboratory, Tianjin Mental Health Centre, Tianjin Anding Hospital, Mental Health Teaching Hospital of Tianjin Medical University, Tianjin, 300222, China

    Chuanjun Zhuo & Hongjun Tian

  4. Department of OCT, Tianjin Eye Hospital, Tianjin, 300034, China

    Bo Xiao

  5. Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China

    Yong Xu

  6. MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, China

    Yong Xu

  7. Co-collaboration Laboratory of China and Canada, Xiamen Xianyue Hospital and University of Alberta, Xiamen, 361000, Fujian, China

    Wenqiang Wang

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  1. Chuanjun Zhuo
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  3. Feng Ji
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  5. Deguo Jiang
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  7. Yong Xu
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  8. Wenqiang Wang
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  9. Ce Chen
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Contributions

CZ, XL, and HT planned the study. CC, GL, FJ, JP, and LW enrolled the patients. CC, DJ, Xd-L and HT analysed the data and drafted the manuscript. GL, and HT developed the statistical methods and analysed the data. All authors contributed to interpreting the results, critically evaluating the data and writing the manuscript.

Corresponding authors

Correspondence to Chuanjun Zhuo or Ce Chen.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The present study was approved by the Ethics Committees of Tianjin Anding Hospital, Wenzhou Seventh People’s Hospital (ZS2017011), Tianjin Kangtai Hospital (KT2016001), Jinning Medical University (2015–09-009), and Shanxi Medical University (2015-K001). This multicenter large-sample cohort study was also approved by the Ethics Committee of Joint Research Group (2014-TWJS-01). All procedures performed in studies involving human participants were in accordance with the ethics standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethics standards.

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Zhuo, C., Xiao, B., Ji, F. et al. Patients with first-episode untreated schizophrenia who experience concomitant visual disturbances and auditory hallucinations exhibit co-impairment of the brain and retinas—a pilot study. Brain Imaging and Behavior 15, 1533–1541 (2021). https://doi.org/10.1007/s11682-020-00351-1

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