The early stage of psychosis (ESP) is a critical period where effective intervention has the most favorable impact on outcomes. Thalamic connectivity abnormalities have been consistently found in psychosis, and are associated with clinical symptoms and cognitive deficits. However, most studies consider ESP patients as a homogeneous population and fail to take the duration of illness into account. In this study, we aimed to capture the progression of thalamic connectivity changes over the first five years of psychosis. Resting-state functional MRI scans were collected from 156 ESP patients (44 with longitudinal data) and 82 healthy controls (24 with longitudinal data). We first performed a case-control analysis comparing thalamic connectivity with 13 networks in the cortex and cerebellum. Next, we modelled the shape (flat, linear, curvilinear) of thalamic connectivity trajectories by comparing flexible non-linear versus linear models. We then tested the significance of the duration of illness and diagnosis in trajectories that changed over time. Connectivity changed over the ESP period between the thalamus and default mode network (DMN) and fronto-parietal network (FPN) nodes in both the cortex and cerebellum. Three models followed a curvilinear trajectory (early increase followed by a subsequent decrease), while thalamo-cerebellar FPN connectivity followed a linear trajectory of steady reductions over time, indicating different rates of change. Finally, diagnosis significantly predicted thalamic connectivity. Thalamo-cortical and thalamo-cerebellar connectivity change in a dynamic fashion during the ESP period. A better understanding of these changes may provide insights into the compensatory and progressive changes in functional connectivity in the early stages of illness.

精神病早期 (ESP) 是有效干预对结果产生最有利影响的关键时期。丘脑连接异常一直在精神病中被发现，并且与临床症状和认知缺陷有关。然而，大多数研究将 ESP 患者视为同质人群，而没有将疾病持续时间考虑在内。在这项研究中，我们的目的是捕捉精神病前五年丘脑连接变化的进展。从 156 名 ESP 患者（44 名具有纵向数据）和 82 名健康对照（24 名具有纵向数据）中收集了静息状态功能 MRI 扫描。我们首先进行了病例对照分析，比较了丘脑与皮质和小脑中 13 个网络的连通性。接下来，我们对形状（平面、线性、通过比较灵活的非线性模型和线性模型来研究丘脑连接轨迹的曲线）。然后，我们在随时间变化的轨迹中测试了疾病持续时间和诊断的重要性。在 ESP 期间，皮质和小脑中丘脑和默认模式网络 (DMN) 以及额顶叶网络 (FPN) 节点之间的连通性发生了变化。三个模型遵循曲线轨迹（早期增加，随后减少），而丘脑-小脑 FPN 连接遵循线性轨迹，随着时间的推移稳步减少，表明不同的变化率。最后，诊断显着预测了丘脑连通性。在 ESP 期间，丘脑-皮质和丘脑-小脑连接以动态方式变化。