Hippocampal Shape Abnormalities Predict Symptom Progression in Neuroleptic-Free Youth at Ultrahigh Risk for Psychosis
Hippocampal Shape Abnormalities Predict Symptom Progression in Neuroleptic-Free Youth at Ultrahigh Risk for Psychosis
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DOI：
10.1093/schbul/sbv086
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发表时间：
2016-01-01
影响因子：
6.6
通讯作者：
Mittal, Vijay A.
中科院分区：
文献类型：
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作者：
Dean, Derek J.;Orr, Joseph M.;Mittal, Vijay A.
海马神经元异常在精神分裂症谱系人群中得到了广泛的研究，包括精神病高危人群（UHR）。关于海马形态学在向精神病转变之前和期间的研究结果不一致，并且对特定亚区与症状进展的关系知之甚少。共有80名参与者（38名UHR和42名健康对照）接受了3 T MRI扫描，以及结构化的临床访谈。用FSL/FIRST顶点分析进行了前屈肌的形状分析，以获得组间形状差异的局部测量值。一个亚组的样本（24 UHR和24对照组）也返回了12个月的临床随访assessment.The UHR组表现出较小的海马体积双边，形状分析显示，在UHR组的左腹后海马显著倒置。该亚区域的更大倒置与基线时的高血压和12个月后的阳性症状、阴性症状增加以及对正常压力的耐受性受损有关。这是第一个在UHR样本中使用顶点分析的研究，结果表明海马形状的异常似乎反映了驱动疾病进展的潜在致病过程。这些发现表明，检查形状和体积可能为我们对UHR时期大脑变化的概念提供了一个重要的新视角。
Hippocampal abnormalities have been widely studied in schizophrenia spectrum populations including those at ultrahigh risk (UHR) for psychosis. There have been inconsistent findings concerning hippocampal morphology prior to and during the transition to psychosis, and little is known about how specific subregions are related to the symptom progression.A total of 80 participants (38 UHR and 42 healthy controls) underwent a 3T MRI scan, as well as structured clinical interviews. Shape analysis of hippocampi was conducted with FSL/FIRST vertex analysis to yield a localized measure of shape differences between groups. A subgroup of the sample (24 UHR and 24 controls) also returned for a 12-month clinical follow-up assessment.The UHR group exhibited smaller hippocampal volumes bilaterally, and shape analysis revealed significant inversion in the left ventral posterior hippocampus in the UHR group. Greater inversion in this subregion was related to elevated symptomatology at baseline and increased positive symptoms, negative symptoms, and impaired tolerance to normal stress 12 months later. These results did not hold when left hippocampal volume was used as a predictor instead.This represents the first study to use vertex analysis in a UHR sample and results suggest that abnormalities in hippocampal shape appear to reflect underlying pathogenic processes driving the progression of illness. These findings suggest that examining shape and volume may provide an important new perspective for our conception of brain alterations in the UHR period.