Structural Covariance of Cortical Gyrification at Illness Onset in Treatment Resistance: A Longitudinal Study of First-Episode Psychoses.
Structural Covariance of Cortical Gyrification at Illness Onset in Treatment Resistance: A Longitudinal Study of First-Episode Psychoses.
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DOI：
10.1093/schbul/sbab035
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发表时间：
2021-10-21
影响因子：
6.6
通讯作者：
Dazzan P
中科院分区：
文献类型：
--
作者：
Ajnakina O;Das T;Lally J;Di Forti M;Pariante CM;Marques TR;Mondelli V;David AS;Murray RM;Palaniyappan L;Dazzan P
首发精神病（FEP）患者的治疗抵抗（TR）是残疾和功能障碍的主要原因，但对这种严重疾病的机制知之甚少。由于一种观点认为TR具有神经发育根源，我们研究了其出现是否与使用基于回旋的连接体量化的同步皮质成熟中断有关。70例FEP患者在首次就诊时接受精神科服务评估，使用临床记录随访4年;其中17例（24.3%）符合TR定义，53例（75.7%）在4年时仍为非TR。在首次接触抗精神病药物后5周内获得结构MRI图像。使用FreeSurfer计算了148个相邻皮质区域的局部旋转指数;使用折刀程序量化了每个受试者对基于组的结构协方差的贡献，为每个受试者提供了单个偏差矩阵。后者用于推导拓扑性质，使用功能数据分析方法在TR和非TR患者之间进行比较。与非TR患者相比，TR患者的小世界性显著降低（Hedges g = 2.09，P < .001），聚类系数降低（Hedges g = 1.07，P < .001），长度增加（Hedges g =-2.17，P <.001），表明皮质折叠的组织原则被破坏。在整个样本中，具有更明显的小世界性的患者的阳性症状负担更高（r = 0.41，P = 0.001）。从基线MRI结构协方差推断的同步皮质发育轨迹突出了基于个体化的基于回旋的连接体前瞻性识别TR高风险患者的可能性。
Treatment resistance (TR) in patients with first-episode psychosis (FEP) is a major cause of disability and functional impairment, yet mechanisms underlying this severe disorder are poorly understood. As one view is that TR has neurodevelopmental roots, we investigated whether its emergence relates to disruptions in synchronized cortical maturation quantified using gyrification-based connectomes. Seventy patients with FEP evaluated at their first presentation to psychiatric services were followed up using clinical records for 4 years; of these, 17 (24.3%) met the definition of TR and 53 (75.7%) remained non-TR at 4 years. Structural MRI images were obtained within 5 weeks from first exposure to antipsychotics. Local gyrification indices were computed for 148 contiguous cortical regions using FreeSurfer; each subject’s contribution to group-based structural covariance was quantified using a jack-knife procedure, providing a single deviation matrix for each subject. The latter was used to derive topological properties that were compared between TR and non-TR patients using a Functional Data Analysis approach. Compared to the non-TR patients, TR patients showed a significant reduction in small-worldness (Hedges’s g = 2.09, P < .001) and a reduced clustering coefficient (Hedges’s g = 1.07, P < .001) with increased length (Hedges’s g = −2.17, P < .001), indicating a disruption in the organizing principles of cortical folding. The positive symptom burden was higher in patients with more pronounced small-worldness (r = .41, P = .001) across the entire sample. The trajectory of synchronized cortical development inferred from baseline MRI-based structural covariance highlights the possibility of identifying patients at high-risk of TR prospectively, based on individualized gyrification-based connectomes.
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影响因子：
5.7
作者：
Fischl, B;Sereno, MI;Dale, AM
通讯作者：
Dale, AM
影响因子：
5.7
作者：
Bassett, Danielle S.;Nelson, Brent G.;Mueller, Bryon A.;Camchong, Jazmin;Lim, Kelvin O.
通讯作者：
Lim, Kelvin O.
影响因子：
4.4
作者：
Fried EI;van Borkulo CD;Cramer AO;Boschloo L;Schoevers RA;Borsboom D
通讯作者：
Borsboom D
影响因子：
5.7
作者：
Evans, Alan C.
通讯作者：
Evans, Alan C.
影响因子：
25.8
作者：
Das, Tushar;Borgwardt, Stefan;Schmidt, Andre
通讯作者：
Schmidt, Andre