Neuroanatomical abnormalities in first-episode psychosis across independent samples: a multi-centre mega-analysis.
Neuroanatomical abnormalities in first-episode psychosis across independent samples: a multi-centre mega-analysis.
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DOI：
10.1017/s0033291719003568
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发表时间：
2021-01
影响因子：
6.9
通讯作者：
Mechelli A
中科院分区：
文献类型：
--
作者：
Vieira S;Gong Q;Scarpazza C;Lui S;Huang X;Crespo-Facorro B;Tordesillas-Gutierrez D;de la Foz VO;Setien-Suero E;Scheepers F;van Haren NEM;Kahn R;Reis Marques T;Ciufolini S;Di Forti M;Murray RM;David A;Dazzan P;McGuire P;Mechelli A
首发精神病（FEP）的神经解剖异常往往是微妙而广泛的。绝大多数以前的研究都使用了小样本，因此可能不够有力。此外，大多数研究都是在一个研究地点检查参与者，因此结果可能是特定于当地样本调查。因此，现有文献中报告的结果是高度异质性的。本研究旨在通过测试FEP患者的神经解剖学异常来克服这些问题，这些异常在几个独立样本中表达一致。结构磁共振成像数据从五个站点的572名FEP和502名年龄和性别相当的健康对照中获得。采用基于体素的形态测量法研究两组间灰质体积（GMV）的差异。在针对多重比较的全族误差校正后，在p < 0.05处进行统计推断。FEP显示双侧额颞、岛叶和枕区GMV普遍降低;这些降低不依赖于抗精神病药物。下降最明显的区域-直回-与阳性和阴性症状的严重程度呈负相关。本研究确定了一个一致的模式，额颞，岛叶和枕叶异常在五个独立的FEP样本，此外，这些改变的程度取决于症状的严重程度和病程。这为FEP中可靠的神经解剖学改变提供了证据，其表达高于抗精神病药物、扫描参数和招募标准的部位相关差异。
Neuroanatomical abnormalities in first-episode psychosis (FEP) tend to be subtle and widespread. The vast majority of previous studies have used small samples, and therefore may have been underpowered. In addition, most studies have examined participants at a single research site, and therefore the results may be specific to the local sample investigated. Consequently, the findings reported in the existing literature are highly heterogeneous. This study aimed to overcome these issues by testing for neuroanatomical abnormalities in individuals with FEP that are expressed consistently across several independent samples. Structural Magnetic Resonance Imaging data were acquired from a total of 572 FEP and 502 age and gender comparable healthy controls at five sites. Voxel-based morphometry was used to investigate differences in grey matter volume (GMV) between the two groups. Statistical inferences were made at p < 0.05 after family-wise error correction for multiple comparisons. FEP showed a widespread pattern of decreased GMV in fronto-temporal, insular and occipital regions bilaterally; these decreases were not dependent on anti-psychotic medication. The region with the most pronounced decrease – gyrus rectus – was negatively correlated with the severity of positive and negative symptoms. This study identified a consistent pattern of fronto-temporal, insular and occipital abnormalities in five independent FEP samples; furthermore, the extent of these alterations is dependent on the severity of symptoms and duration of illness. This provides evidence for reliable neuroanatomical alternations in FEP, expressed above and beyond site-related differences in anti-psychotic medication, scanning parameters and recruitment criteria.