Reduced volume in the anterior internal capsule but its maintained correlation with the frontal gray matter in subjects at ultra-high risk for psychosis

The anterior limb of the internal capsule (ALIC), which interconnects with the frontal cortex and thalamus, is volumetrically altered in schizophrenia patients. However, it is unclear whether an abnormal ALIC volume is apparent prior to the onset of schizophrenia and whether this aberrant ALIC volume is related to the frontal gray matter in individuals at ultra-high risk (UHR) for psychosis. We used magnetic resonance imaging of 43 UHR subjects, 36 schizophrenia patients, and 42 healthy controls to investigate manually traced ALIC volumes. Additionally, we evaluated the correlation between the ALIC volume and the frontal gray matter. Significantly reduced ALIC volumes were observed in the UHR and schizophrenia groups compared to the healthy controls. However, the volume of the frontal gray matter was decreased only in the schizophrenia group. A positive correlation between the volumes in the ALIC and frontal gray matter found in healthy controls was maintained only in UHR subjects. In addition, a negative correlation between the total scores on the Positive and Negative Syndrome Scale and the ALIC volumes was observed only in schizophrenia patients. An aberrant ALIC volume but its maintained correlation with the interconnecting frontal lobe was present prior to the onset of full psychosis, indicating the prodromal phase of psychosis.