Progressive brain changes in children and adolescents with early-onset psychosis: A meta-analysis of longitudinal MRI studies
Progressive brain changes in children and adolescents with early-onset psychosis: A meta-analysis of longitudinal MRI studies
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DOI：
10.1016/j.schres.2014.12.022
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发表时间：
2016-06-01
影响因子：
4.5
通讯作者：
Arango, Celso
中科院分区：
文献类型：
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作者：
Fraguas, David;Diaz-Caneja, Covadonga M.;Arango, Celso
背景：早发性精神病（EOP）患者纵向脑容量变化的研究对于了解与精神病相关的脑异常的神经生物学基础特别有价值。然而，在这一人群中进行的研究结果并不一致。我们的目的是对EOP儿童和青少年的进行性脑容量变化进行荟萃分析。方法：系统检索磁共振成像（MRI）研究资料，比较EOP儿童和青少年与健康对照组的纵向脑容量变化。按感兴趣区域（ROI）计算的脑容量的年化相对变化率被用作meta分析的原始数据。年龄、性别、病程和特定诊断对体积变化的影响也进行了评估。结果：纳入了5项原始研究，156例EOP患者（5项研究的基线MRI平均年龄为13.3 - 16.6岁，67.31%为男性）和163例年龄和性别匹配的健康对照，平均随访时间为2.46年（2.02-3.40年）。额叶灰质（GM）是患者和对照组之间唯一体积随时间变化有显著差异的区域（Hedges' g = 0.435, 95%可信区间（CI）：-0.678 ~ -0.193, p < 0.001）。与对照组相比，基线MRI时年龄较小的患者随着时间的推移，颞部GM体积的损失更大（p = 0.005）。在患者中，诊断为精神分裂症与枕骨GM体积随时间的增加有关（p = 0.001）。结论：与健康个体相比，EOP患者在发病后的最初几年表现出更大的进行性额叶GM丧失。基线MRI年龄和精神分裂症诊断似乎是特定脑容量变化的显著调节因子。(C) 2014 Elsevier B.V.版权所有
Background: Studies on longitudinal brain volume changes in patients with early-onset psychosis (EOP) are particularly valuable for understanding the neurobiological basis of brain abnormalities associated with psychosis. However, findings have not been consistent across studies in this population. We aimed to conduct a meta-analysis on progressive brain volume changes in children and adolescents with EOP.Methods: A systematic literature search of magnetic resonance imaging (MRI) studies comparing longitudinal brain volume changes in children and adolescents with EOP and healthy controls was conducted. The annualized rates of relative change in brain volume by region of interest (ROI) were used as raw data for the meta-analysis. The effect of age, sex, duration of illness, and specific diagnosis on volume change was also evaluated.Results: Five original studies with 156 EOP patients (mean age at baseline MRI in the five studies ranged from 13.3 to 16.6 years, 67.31% males) and 163 age- and sex-matched healthy controls, with a mean duration of follow-up of 2.46 years (range 2.02-3.40), were included. Frontal gray matter (GM) was the only region in which significant differences in volume change over time were found between patients and controls (Hedges' g-0.435, 95% confidence interval (CI):-0.678 to -0.193, p < 0.001). Younger age at baseline MRI was associated with greater loss of temporal GM volume over time in patients as compared with controls (p = 0.005). Within patients, a diagnosis of schizophrenia was related to greater occipital GM volume loss over time (p = 0.001).Conclusions: Compared with healthy individuals, EOP patients show greater progressive frontal GM loss over the first few years after illness onset. Age at baseline MRI and diagnosis of schizophrenia appear to be significant moderators of particular specific brain volume changes. (C) 2014 Elsevier B.V. All rights reserved.