Subtyping Schizophrenia Patients Based on Patterns of Structural Brain Alterations.
Subtyping Schizophrenia Patients Based on Patterns of Structural Brain Alterations.
复制标题
DOI：
10.1093/schbul/sbab110
复制
发表时间：
2021-09
影响因子：
6.6
通讯作者：
Yuan Xiao;W. Liao;Zhiliang Long;B. Tao;Qiannan Zhao;C. Luo;C. Tamminga;M. Keshavan;G. Pearlson;B. Clementz;E. Gershon;E. Ivleva;S. Keedy;B. Biswal;A. Mechelli;R. Lencer;J. Sweeney;S. Lui;Q. Gong
中科院分区：
文献类型：
--
作者：
Yuan Xiao;W. Liao;Zhiliang Long;B. Tao;Qiannan Zhao;C. Luo;C. Tamminga;M. Keshavan;G. Pearlson;B. Clementz;E. Gershon;E. Ivleva;S. Keedy;B. Biswal;A. Mechelli;R. Lencer;J. Sweeney;S. Lui;Q. Gong
精神分裂症是一种复杂且异质的综合征。定量成像生物标志物是否可以识别离散的患者亚组，并可用于促进患者护理的个性化医疗方法，目前尚不清楚。招募了来自双相情感障碍和精神分裂症中间表型网络 (B-SNIP) 联盟的 163 名从未治疗过的首发精神分裂症患者 (FES) 和 133 名患有中期精神分裂症的慢性病患者以及总共 403 名健康对照者的横截面结构 MR 图像。提取每个受试者的形态测量指标（皮质厚度、表面积和皮质下结构），然后通过非监督聚类分析获得优化的子分型结果。 FES 中确定了由区域皮质和皮质下形态特征的不同模式定义的三个患者亚组。在来自多站点 B-SNIP 联盟的独立患者数据集中发现了类似的三个亚组模式。这两个患者队列的分类模式的相似性表明，三组类型在病程中相对稳定。中度精神分裂症亚组 1 的认知功能比亚组 3 的认知功能更差。这些发现为基于大脑结构特征的精神分裂症患者的不同亚组提供了新的见解。亚组之间不同认知功能的发现支持 MRI 定义的疾病亚型的临床差异。无论临床表现和疾病阶段如何，解剖 MR 亚组生物标志物都可以区分精神分裂症患者神经生物学上不同的亚组，这代表着在区分患者亚型以进行疾病神经生物学研究和潜在的临床试验方面迈出了重要且有意义的一步。
Schizophrenia is a complex and heterogeneous syndrome. Whether quantitative imaging biomarkers can identify discrete subgroups of patients as might be used to foster personalized medicine approaches for patient care remains unclear. Cross-sectional structural MR images of 163 never-treated first-episode schizophrenia patients (FES) and 133 chronically ill patients with midcourse schizophrenia from the Bipolar and Schizophrenia Network for Intermediate Phenotypes (B-SNIP) consortium and a total of 403 healthy controls were recruited. Morphometric measures (cortical thickness, surface area, and subcortical structures) were extracted for each subject and then the optimized subtyping results were obtained with nonsupervised cluster analysis. Three subgroups of patients defined by distinct patterns of regional cortical and subcortical morphometric features were identified in FES. A similar three subgroup pattern was identified in the independent dataset of patients from the multi-site B-SNIP consortium. Similarities of classification patterns across these two patient cohorts suggest that the 3-group typology is relatively stable over the course of illness. Cognitive functions were worse in subgroup 1 with midcourse schizophrenia than those in subgroup 3. These findings provide novel insight into distinct subgroups of patients with schizophrenia based on structural brain features. Findings of different cognitive functions among the subgroups support clinical differences in the MRI-defined illness subtypes. Regardless of clinical presentation and stage of illness, anatomic MR subgrouping biomarkers can separate neurobiologically distinct subgroups of schizophrenia patients, which represent an important and meaningful step forward in differentiating subtypes of patients for studies of illness neurobiology and potentially for clinical trials.