Accelerated Brain Aging in Schizophrenia and Beyond: A Neuroanatomical Marker of Psychiatric Disorders
Accelerated Brain Aging in Schizophrenia and Beyond: A Neuroanatomical Marker of Psychiatric Disorders
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DOI：
10.1093/schbul/sbt142
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发表时间：
2014-09-01
影响因子：
6.6
通讯作者：
Meisenzahl, Eva
中科院分区：
文献类型：
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作者：
Koutsouleris, Nikolaos;Davatzikos, Christos;Meisenzahl, Eva
大脑结构异常是精神分裂症（SZ）的核心特征，但它们是否与跨越诊断界限的发育不良过程相关、是否在疾病阶段中加重以及是否驱动该疾病的神经诊断特征，这些仍然未知。因此，我们研究了精神分裂症患者（N = 141）、重度抑郁症患者（MD；N = 104）、边缘性人格障碍患者（BPD；N = 57）以及处于精神病风险精神状态的个体（ARMS；N = 89）是否偏离了正常大脑成熟的轨迹。这种偏离是通过测量实际年龄和神经解剖年龄之间的差异（大脑年龄差距估计[BrainAGE]）来衡量的。神经解剖年龄是由一个机器学习系统确定的，该系统经过训练，能够根据800名健康对照者的结构磁共振成像来单独估计年龄。组水平分析表明，精神分裂症组的BrainAGE最高（+5.5岁），其次是重度抑郁症组（+4.0岁）、边缘性人格障碍组（+3.1岁）和处于精神病风险状态组（+1.7岁）。重度抑郁症和边缘性人格障碍组中发病越早，BrainAGE越显著，达到精神分裂症组的效应量。其次，在精神分裂症的风险期、近期发病期和复发期，BrainAGE会增加。最后，BrainAGE能够预测患者状态以及阴性和紊乱症状。这些发现表明，一种可单独量化的“加速衰老”效应可能尤其对精神分裂症的神经解剖特征有影响，但也可能延伸到其他精神障碍。
Structural brain abnormalities are central to schizophrenia (SZ), but it remains unknown whether they are linked to dysmaturational processes crossing diagnostic boundaries, aggravating across disease stages, and driving the neurodiagnostic signature of the illness. Therefore, we investigated whether patients with SZ (N = 141), major depression (MD; N = 104), borderline personality disorder (BPD; N = 57), and individuals in at-risk mental states for psychosis (ARMS; N = 89) deviated from the trajectory of normal brain maturation. This deviation was measured as difference between chronological and the neuroanatomical age (brain age gap estimation [BrainAGE]). Neuroanatomical age was determined by a machine learning system trained to individually estimate age from the structural magnetic resonance imagings of 800 healthy controls. Group-level analyses showed that BrainAGE was highest in SZ (+5.5 y) group, followed by MD (+4.0), BPD (+3.1), and the ARMS (+1.7) groups. Earlier disease onset in MD and BPD groups correlated with more pronounced BrainAGE, reaching effect sizes of the SZ group. Second, BrainAGE increased across at-risk, recent onset, and recurrent states of SZ. Finally, BrainAGE predicted both patient status as well as negative and disorganized symptoms. These findings suggest that an individually quantifiable "accelerated aging" effect may particularly impact on the neuroanatomical signature of SZ but may extend also to other mental disorders.