Intrinsic brain network connectivity is already altered in first-episode psychosis (FEP), but the longitudinal trajectories of network connectivity, especially in response to antipsychotic treatment, remain poorly understood. The goal of this study was to investigate how antipsychotic medications affect higher-order intrinsic brain network connectivity in FEP. Data from 87 antipsychotic medication-naïve patients with FEP and 87 healthy control participants were used. Medication-naïve patients received antipsychotic treatment for 16 weeks. Resting-state functional connectivity (FC) of the default mode, salience, dorsal attention, and executive control networks were assessed prior to treatment and at 6 and 16 weeks after treatment. We evaluated baseline and FC changes using linear mixed models to test group × time interactions within each network. Associations between FC changes after 16 weeks and response to treatment were also evaluated. Prior to treatment, significant group differences in all networks were found. However, significant trajectory changes in FC were found only in the default mode and executive control networks. Changes in FC in these networks were associated with treatment response. Several sensitivity analyses showed a consistent normalization of executive control network FC in response to antipsychotic treatment. Here, we found that alterations in intrinsic brain network FC were not only alleviated with antipsychotic treatment, but the extent of this normalization was also associated with the degree of reduction in symptom severity. Taken together, our data suggest modulation of intrinsic brain network connectivity (mainly frontoparietal connectivity) as a mechanism underlying antipsychotic treatment response in FEP.

中文翻译：

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首次发作精神病患者接受抗精神病药物治疗后的高阶内在脑网络轨迹

在首发精神病（FEP）中，内在的大脑网络连接已经发生改变，但网络连接的纵向轨迹，特别是对抗精神病治疗的反应，仍然知之甚少。本研究的目的是调查抗精神病药物如何影响 FEP 中高阶内在脑网络连接。使用的数据来自 87 名未接受过抗精神病药物治疗的 FEP 患者和 87 名健康对照参与者。未接受过药物治疗的患者接受了 16 周的抗精神病药物治疗。在治疗前以及治疗后 6 周和 16 周时评估默认模式、显着性、背侧注意力和执行控制网络的静息态功能连接 (FC)。我们使用线性混合模型评估基线和 FC 变化，以测试每个网络内的组 × 时间交互。还评估了 16 周后 FC 变化与治疗反应之间的关联。在治疗之前，所有网络中都发现了显着的群体差异。然而，仅在默认模式和执行控制网络中发现 FC 的显着轨迹变化。这些网络中 FC 的变化与治疗反应相关。多项敏感性分析显示执行控制网络 FC 对抗精神病药物治疗的反应一致正常化。在这里，我们发现内在大脑网络 FC 的改变不仅可以通过抗精神病药物治疗得到缓解，而且这种正常化的程度也与症状严重程度的降低程度相关。总而言之，我们的数据表明，内在大脑网络连接（主要是额顶叶连接）的调节是 FEP 抗精神病治疗反应的潜在机制。