Changes in neurovascular coupling of cerebral blood flow and functional connectivity strength in first-episode schizophrenia patients after antipsychotic treatment.

Previous studies have identified abnormalities in neurovascular coupling in chronic schizophrenia patients based on functional connectivity strength (FCS) and cerebral blood flow (CBF). Pharmacological treatment remains the cornerstone of schizophrenia management. However, it remains unclear whether antipsychotic treatment influences these findings. This study aimed to investigate potential abnormalities in neurovascular coupling in patients with first-episode schizophrenia (FES) and to explore changes before (FES-pre) and after antipsychotic treatment (FES-post). Here, we recruited 133 FES patients and 149 normal controls and used CBF-FCS correlation of the entire gray matter and CBF/FCS ratio of each voxel to evaluate changes in coupling changes in FES patients at baseline and after treatment. Compared with normal controls, FES patients exhibited significantly reduced whole-brain CBF-FCS correlation coefficients, significantly reduced CBF/FCS ratio in bilateral parahippocampal gyri, the medial part of bilateral superior frontal gyri, and left anterior cingulate gyrus, and enhanced CBF/FCS ratios in the left calcarine sulcus, left lingual gyrus, left superior temporal gyrus, and bilateral postcentral gyri. FES-post showed increased FCS in the left postcentral gyrus but decreased FCS in the left anterior cingulate gyrus, increased CBF in the visual cortex, and increased CBF/FCS ratio in the left middle occipital gyrus and right middle temporal gyrus but decreased ratio in the inferior frontal gyrus. Significantly decreased PANSS scores were found between FES-pre and FES-post. These findings suggest that neurovascular decoupling may represent a potential pathophysiological index in schizophrenia, and antipsychotic treatment not only ameliorate clinical symptoms but also modulate brain function, perfusion, and neurovascular coupling.