Characterising grey-white matter relationships in recent-onset psychosis and its association with cognitive function

Individuals with recent-onset psychosis (ROP) present widespread grey matter (GM) reductions and white matter (WM) abnormalities. While prior studies used univariate approaches, understanding how multiple GM regions relate to WM tracts is important, as psychosis involves network-level brain dysfunction. Understanding characteristic GM-WM patterns may also clarify the basis of cognitive impairments, which are potentially linked to network dysfunction in psychosis. Using multivariate analysis, we examined whole-brain GM-WM relationships and their association with cognitive abilities in ROP. We used T1 and diffusion-weighted images from 71 non-affective ROP individuals (age 22.09 ± 3.08) and 71 matched controls (age 22.05 ± 3.21). We performed multiblock partial least squares correlation (MB-PLS-C) to identify GM-WM patterns based on GM thickness or surface area and WM fractional anisotropy (FA), and examined their associations with cognitive abilities. MB-PLS-C identified a 'GM thickness'-'WM FA' pattern representing group differences, explaining 12.38 % of the variance and associated with frontal and temporal GM regions and seven WM tracts around subcortical structures. MB-PLS-C also identified a 'GM surface area'-'WM FA' pattern showing group differences, explaining 18.92 % and related with cingulate, frontal, temporal, and parietal GM regions and 15 WM tracts, including the inferior cerebellar peduncle and corona radiata. The 'GM thickness'-'WM FA' pattern describing group differences was significantly correlated with processing speed in ROP. MB-PLS-C identified differential whole-brain GM-WM relationships, indicating a potential signature of brain alterations in ROP. Our findings of a relationship between processing speed and GM-WM patterns for GM thickness have implications for our understanding of brain-behaviour relationships in psychosis.