Longitudinal loss of gray matter volume in patients with first-episode schizophrenia: DARTEL automated analysis and ROI validation.
Longitudinal loss of gray matter volume in patients with first-episode schizophrenia: DARTEL automated analysis and ROI validation.
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DOI：
10.1016/j.neuroimage.2011.08.066
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发表时间：
2012-01-16
期刊：
影响因子：
5.7
通讯作者：
McCarley, Robert W.
中科院分区：
文献类型：
--
作者：
Asami, Takeshi;Bouix, Sylvain;Whitford, Thomas J.;Shenton, Martha E.;Salisbury, Dean F.;McCarley, Robert W.
感兴趣区（ROI）纵向研究发现，首发精神分裂症（FESZ）患者的灰质（GM）体积进行性减少。然而，只有少数纵向基于体素的形态测定（VBM）研究，这些研究在检测容量损失和症状之间的关系方面受到限制，可能是因为方法学问题。以前的研究也没有将VBM结果与手动感兴趣区域（ROI）分析进行比较和验证。在本VBM研究中，使用高维翘曲和个性化基线重新扫描模板来评估受试者内的纵向体积变化，并与相同受试者的纵向手动ROI分析进行比较。VBM在基线（横断面）评价了33例FESZ和36例匹配的健康对照受试者（HC），并在基线扫描后平均1.5年纵向评价了21例FESZ和23例HC。相关性分析检测FESZ区域GM体积变化与简明精神病评定量表得出的临床症状以及简易精神状态检查评估的认知功能之间的关系。在基线时，FESZ患者在某些区域（包括左上级颞回（STG））的GM体积显著小于HC。在1.5年后的重新扫描，患者表现出显着的GM体积减少相比，HC在左侧STG，包括Heschl的回，并在广泛的大脑新皮层区域的额叶，顶叶，边缘系统区域，包括扣带回。FESZ显示阳性症状与颞叶（特别是STG）和额叶区域的体积损失相关，阴性症状与STG和额叶区域的体积损失相关。认知功能变差与额叶、颞叶和顶叶区域的广泛体积减少有关。验证VBM分析显示的结果类似于我们之前对STG和扣带回的ROI结果。我们的结论是FESZ显示在许多脑区广泛的，渐进的GM体积减少。重要的是，这些减少与更差的临床病程直接相关。与投资回报率分析的一致性表明了这种纵向VBM方法的前景。
Region of Interest (ROI) longitudinal studies have detected progressive gray matter (GM) volume reductions in patients with first-episode schizophrenia (FESZ). However, there are only a few longitudinal voxel-based morphometry (VBM) studies, and these have been limited in ability to detect relationships between volume loss and symptoms, perhaps because of methodologic issues. Nor have previous studies compared and validated VBM results with manual Region of Interest (ROI) analysis. In the present VBM study, high-dimensional warping and individualized baseline-rescan templates were used to evaluate longitudinal volume changes within subjects and compared with longitudinal manual ROI analysis on the same subjects. VBM evaluated thirty-three FESZ and thirty-six matched healthy control subjects (HC) at baseline (cross-sectionally) and longitudinally evaluated 21 FESZ and 23 HC after an average of 1.5 years from baseline scans. Correlation analyses detected the relationship between changes in regional GM volumes in FESZ and clinical symptoms derived from the Brief Psychiatric Rating Scale, as well as cognitive function as assessed by the Mini-Mental State Examination. At baseline, patients with FESZ had significantly smaller GM volume compared to HC in some regions including the left superior temporal gyrus (STG). On rescan after 1.5 years, patients showed significant GM volume reductions compared with HC in the left STG including Heschl's gyrus, and in widespread brain neocortical regions of frontal, parietal, and limbic regions including the cingulate gyrus. FESZ showed an association of positive symptoms and volume loss in temporal (especially STG) and frontal regions, and negative symptoms and volume loss in STG and frontal regions. Worse cognitive function was linked to widespread volume reduction, in frontal, temporal and parietal regions. The validation VBM analyses showed results similar to our previous ROI findings for STG and Cingulate Gyrus. We conclude FESZ show widespread, progressive GM volume reductions in many brain regions. Importantly, these reductions are directly associated with a worse clinical course. Congruence with ROI analyses suggests the promise of this longitudinal VBM methodology.
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