Network-Level Dysconnectivity in Drug-Naïve First-Episode Psychosis: Dissociating Transdiagnostic and Diagnosis-Specific Alterations.
Network-Level Dysconnectivity in Drug-Naïve First-Episode Psychosis: Dissociating Transdiagnostic and Diagnosis-Specific Alterations.
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初次用药精神病中的网络级脱节：分离跨诊断和诊断特异性改变
DOI：
10.1038/npp.2016.247
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发表时间：
2017-03
期刊：
影响因子：
--
通讯作者：
Mechelli A
中科院分区：
文献类型：
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作者：
Gong Q;Hu X;Pettersson-Yeo W;Xu X;Lui S;Crossley N;Wu M;Zhu H;Mechelli A
神经影像学文献为精神病患者的功能性连接障碍提供了令人信服的证据。然而，至少有一些观察到的变化可能代表疾病慢性化和/或抗精神病药物的继发性影响。此外，这些改变在多大程度上是精神病特有的或代表精神疾病的转诊断特征仍不清楚。因此，本研究的目的是检查首次用药精神病（FEP）功能连接障碍的诊断特异性。我们使用静息态功能磁共振成像和功能连接分析来评估50例FEP患者、50例重度抑郁症（MDD）患者、50例创伤后应激障碍（PTSD）患者和122例健康对照（HC）的网络水平连接。与HC组相比，FEP、MDD和PTSD组显示默认模式网络的内部网络连接性降低（p<0.05）;因此，在三个诊断组中均表现出内部网络改变。此外，与MDD、PTSD和HC组相比，FEP组的默认模式网络（特别是前扣带皮层）和中央执行网络之间的网络连接性增强（p<0.05）;因此，网络间的改变是FEP特有的。这些发现表明，网络水平的改变存在于首次精神病发作的个体中，这些个体没有接触过抗精神病药物。此外，他们认为异常的互联网络连接作为精神病的一个独特特征和异常的内部网络连接作为精神病的一个跨诊断特征之间存在分离。
The neuroimaging literature provides compelling evidence for functional dysconnectivity in people with psychosis. However, it is likely that at least some of the observed alterations represent secondary effects of illness chronicity and/or antipsychotic medication. In addition, the extent to which these alterations are specific to psychosis or represent a transdiagnostic feature of psychiatric illness remains unclear. The aim of this study was therefore to examine the diagnostic specificity of functional dysconnectivity in drug-naïve first-episode psychosis (FEP). We used resting-state functional magnetic resonance imaging and functional connectivity analysis to estimate network-level connectivity in 50 patients with FEP, 50 patients with major depressive disorder (MDD), 50 patients with post-traumatic stress disorder (PTSD), and 122 healthy controls (HCs). The FEP, MDD, and PTSD groups showed reductions in intranetwork connectivity of the default mode network relative to the HC group (p<0.05 corrected); therefore, intranetwork alterations were expressed across the three diagnostic groups. In addition, the FEP group showed heightened internetwork connectivity between the default mode network, particularly the anterior cingulate cortex, and the central executive network relative to the MDD, PTSD, and HC groups (p<0.05 corrected); therefore, internetwork alterations were specific to the FEP. These findings suggest that network-level alterations are present in individuals with a first episode of psychosis who have not been exposed to antipsychotic medication. In addition, they suggest a dissociation between aberrant internetwork connectivity as a distinctive feature of psychosis and aberrant intranetwork connectivity as a transdiagnostic feature of psychiatric illness.