Zhang X, Yang M, Du X, et al. - Researchers examined the inter-relationships between glucose disturbances, cognitive deficits, and white matter abnormalities in drug-naive first-episode (DNFE) patients with schizophrenia. They examined 39 DNFE schizophrenia and 31 control subjects, and identified significantly greater fasting plasma levels of glucose and insulin and homeostasis model of assessment-insulin resistance index among patients. Further, the patients had poorer cognitive scores, together with widespread reduced fractional anisotropy (FA) values in five brain areas, including left and right corpus callosum, superior longitudinal fasciculus, posterior thalamic radiation, and corona radiata. As per association analysis, there was a positive association between glucose level and Digital Sequence Test and Continuous Performance Test; however, there was a negative association between glucose level and FA values in posterior thalamic radiation and left corpus callosum in patients. Moreover, multiple regression analysis revealed an independent contribution of the interactions of glucose × FA in left corpus callosum, longitudinal fasciculus and corona radiata to the Brief Visuospatial Memory Test of MATRICS Consensus Cognitive Battery (MCCB), while there was an association of the interaction of glucose × FA in left corpus callosum, or in longitudinal fasciculus with MCCB mazes and Trail Making A Test, respectively. These findings thereby suggested that patients with an early course of schizophrenia onset show an abnormal glucose metabolism, cognitive impairment and widespread disruption of white matter (WM) structure. Cognitive impairment could be due to an interaction between glucose metabolism abnormality and the WM dysconnectivity.