Progressive Decline in Hippocampal CA1 Volume in Individuals at Ultra-High-Risk for Psychosis Who Do Not Remit: Findings from the Longitudinal Youth at Risk Study.
Progressive Decline in Hippocampal CA1 Volume in Individuals at Ultra-High-Risk for Psychosis Who Do Not Remit: Findings from the Longitudinal Youth at Risk Study.
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DOI：
10.1038/npp.2017.5
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发表时间：
2017-05
期刊：
影响因子：
--
通讯作者：
Zhou J
中科院分区：
文献类型：
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作者：
Ho NF;Holt DJ;Cheung M;Iglesias JE;Goh A;Wang M;Lim JK;de Souza J;Poh JS;See YM;Adcock AR;Wood SJ;Chee MW;Lee J;Zhou J
大多数被确定为精神病超高风险 (UHR) 的人并没有发展为明显的精神病。他们继续表现出阈下症状，或者继续完全缓解。先前的研究表明，CA1（海马体的一个子区域）的体积在精神分裂症的早期阶段选择性地减少。在这里，我们的目的是确定在达到或未达到症状缓解的 UHR 个体中 CA1 体积变化模式是否不同。从 147 名 UHR 受试者和健康对照受试者中获取基线和 1-2 个随访时间点（每隔 12 个月）的结构 MRI 扫描。使用自动化方法（基于超高分辨率海马组织的离体图集）来描绘海马子区域。随着时间的推移，与缓解的 UHR 受试者 (n = 41) 和健康对照 (n = 54) 相比，阈下症状持续存在的 UHR 受试者亚组 (n = 40) 以及出现临床精神病的受试者 (n = 12) 的双侧 CA1 亚视野体积下降幅度更大。各组之间未发现整个海马或其子区域体积的基线差异。此外，非缓解者中 CA1（而非其他海马亚区）体积下降的速度与随时间推移症状严重程度的增加相关。因此，这些发现表明，在持续有症状的 UHR 个体中，CA1 体积的恶化与症状进展成比例。
Most individuals identified as ultra-high-risk (UHR) for psychosis do not develop frank psychosis. They continue to exhibit subthreshold symptoms, or go on to fully remit. Prior work has shown that the volume of CA1, a subfield of the hippocampus, is selectively reduced in the early stages of schizophrenia. Here we aimed to determine whether patterns of volume change of CA1 are different in UHR individuals who do or do not achieve symptomatic remission. Structural MRI scans were acquired at baseline and at 1–2 follow-up time points (at 12-month intervals) from 147 UHR and healthy control subjects. An automated method (based on an ex vivo atlas of ultra-high-resolution hippocampal tissue) was used to delineate the hippocampal subfields. Over time, a greater decline in bilateral CA1 subfield volumes was found in the subgroup of UHR subjects whose subthreshold symptoms persisted (n=40) and also those who developed clinical psychosis (n=12), compared with UHR subjects who remitted (n=41) and healthy controls (n=54). No baseline differences in volumes of the overall hippocampus or its subfields were found among the groups. Moreover, the rate of volume decline of CA1, but not of other hippocampal subfields, in the non-remitters was associated with increasing symptom severity over time. Thus, these findings indicate that there is deterioration of CA1 volume in persistently symptomatic UHR individuals in proportion to symptomatic progression.