Cortical abnormalities in youth at clinical high-risk for psychosis: Findings from the NAPLS2 cohort
Cortical abnormalities in youth at clinical high-risk for psychosis: Findings from the NAPLS2 cohort
复制标题
DOI：
10.1016/j.nicl.2019.101862
复制
发表时间：
2019-01-01
影响因子：
4.2
通讯作者：
Cannon, Tyrone D.
中科院分区：
文献类型：
--
作者：
Chung, Yoonho;Alswede, Dana;Cannon, Tyrone D.
在最近的一项基于横断面神经解剖学数据的机器学习研究中，观察到临床高危(CHR)个体表现出偏离正常神经成熟模式，这反过来预示着更大的转化为精神病的风险和功能结果稳定较差的模式。这些影响是在12至17岁之间的患者中独有的，当他们的前驱症状和精神症状开始时，表明在确定CHR综合征时观察到的神经解剖学偏差标志着早发性精神病的风险。在目前的研究中，我们试图阐明神经解剖学异常与这种“早发性”精神病形式有关的模式，以及这种异常是否与较差的病前功能有关。分析了来自北美先证者纵向研究(NAPLS2)的378例慢性阻塞性肺疾病患者和190例健康对照(HC)的T-1MRI扫描结果。在基线评估中，与HC相比，CHR个体的皮质体积普遍较小，特别是在年轻组(即12至17岁的人群)中。此外，与在随访时缓解或表现出稳定的前驱症状的年轻CHR患者相比，在随访中(2年内)转换或表现为临床症状恶化的年轻CHR患者在嘴前扣带回、外侧和内侧前额叶区域以及海马旁回的表面积较小。反过来，儿童期较差的病前功能与眶前内侧、额侧、嘴前扣带、楔前和颞区的表面积较小有关。结合我们先前的报告，这些结果与以下观点一致：在青春期早期表现出的神经解剖学异常标志着一种精神病的脆弱性，这种精神病表现为病前适应能力差、发病年龄较早(通常在18岁之前)和长期结果差。
In a recent machine learning study classifying "brain age" based on cross-sectional neuroanatomical data, clinical high-risk (CHR) individuals were observed to show deviation from the normal neuromaturational pattern, which in turn was predictive of greater risk of conversion to psychosis and a pattern of stably poor functional outcome. These effects were unique to cases who were between 12 and 17 years of age when their prodromal and psychotic symptoms began, suggesting that neuroanatomical deviance observable at the point of ascertainment of a CHR syndrome marks risk for an early onset form of psychosis. In the present study, we sought to clarify the pattern of neuroanatomical deviance linked to this "early onset" form of psychosis and whether this deviance is associated with poorer premorbid functioning. T-1 MRI scans from 378 CHR individuals and 190 healthy controls (HC) from the North American Prodrome Longitudinal Study (NAPLS2) were analyzed. Widespread smaller cortical volume was observed among CHR individuals compared with HC at baseline evaluation, particularly among the younger group (i.e., those who were 12 to 17 years of age). Moreover, the younger CHR individuals who converted or presented worsened clinical symptoms at follow-up (within 2 years) exhibited smaller surface area in rostral anterior cingulate, lateral and medial prefrontal regions, and para-hippocampal gyrus relative to the younger CHR individuals who remitted or presented a stable pattern of prodromal symptoms at follow-up. In turn, poorer premorbid functioning in childhood was associated with smaller surface area in medial orbitofrontal, lateral frontal, rostral anterior cingulate, precuneus, and temporal regions. Together with our prior report, these results are consistent with the view that neuroanatomical deviance manifesting in early adolescence marks vulnerability to a form of psychosis presenting with poor premorbid adjustment, an earlier age of onset (generally prior to the age of 18 years), and poor long-term outcome.