White matter integrity as a predictor of response to treatment in first episode psychosis.
White matter integrity as a predictor of response to treatment in first episode psychosis.
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DOI：
10.1093/brain/awt310
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发表时间：
2014-01
期刊：
影响因子：
--
通讯作者：
Dazzan P
中科院分区：
文献类型：
--
作者：
Reis Marques T;Taylor H;Chaddock C;Dell'acqua F;Handley R;Reinders AA;Mondelli V;Bonaccorso S;Diforti M;Simmons A;David AS;Murray RM;Pariante CM;Kapur S;Dazzan P
大脑白色物质连接的完整性对于患者对药物干预的反应能力至关重要。本研究使用白色物质完整性的特定测量来检验这一假设，并在首次精神病发作的患者中使用前瞻性设计来检查其与治疗反应的关系。在63例首发精神病患者和52例健康对照受试者（基线）中采集弥散张量成像数据。在12周后评估反应，并根据治疗结果将患者分类为反应者或非反应者。在第二个时间点，他们还接受了第二次扩散张量成像扫描。基于道的空间统计被用来评估分数各向异性作为白色物质完整性的标志。在基线时，无应答者表现出比应答者和健康对照受试者更低的各向异性分数（P < 0.05;家族误差校正），主要在钩椎、扣带和胼胝体中，而应答者与健康对照受试者无法区分。12周后，应答者和非应答者的各向异性分数均增加，与抗精神病药物暴露呈正相关。这是一个最大的，对照研究的白色物质的完整性和抗精神病药物治疗早期精神病的反应。这些数据，以及早期的研究结果，对皮质灰质，表明，灰质和白色物质的完整性在治疗开始时是一个重要的调解人的反应，抗精神病药物。这些发现可以告知患者分层以预测护理需求，并提高抗精神病药物可能恢复白色物质完整性作为治疗反应的一部分的可能性。
The integrity of brain white matter connections is central to a patient’s ability to respond to pharmacological interventions. This study tested this hypothesis using a specific measure of white matter integrity, and examining its relationship to treatment response using a prospective design in patients within their first episode of psychosis. Diffusion tensor imaging data were acquired in 63 patients with first episode psychosis and 52 healthy control subjects (baseline). Response was assessed after 12 weeks and patients were classified as responders or non-responders according to treatment outcome. At this second time-point, they also underwent a second diffusion tensor imaging scan. Tract-based spatial statistics were used to assess fractional anisotropy as a marker of white matter integrity. At baseline, non-responders showed lower fractional anisotropy than both responders and healthy control subjects (P < 0.05; family-wise error-corrected), mainly in the uncinate, cingulum and corpus callosum, whereas responders were indistinguishable from healthy control subjects. After 12 weeks, there was an increase in fractional anisotropy in both responders and non-responders, positively correlated with antipsychotic exposure. This represents one of the largest, controlled investigations of white matter integrity and response to antipsychotic treatment early in psychosis. These data, together with earlier findings on cortical grey matter, suggest that grey and white matter integrity at the start of treatment is an important moderator of response to antipsychotics. These findings can inform patient stratification to anticipate care needs, and raise the possibility that antipsychotics may restore white matter integrity as part of the therapeutic response.
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影响因子：
4.5
作者：
Bartzokis, George;Lu, Po H.;Stewart, Stephanie B.;Oluwadara, Bolanle;Lucas, Andrew J.;Pantages, Joanna;Pratt, Erika;Sherin, Jonathan E.;Altshuler, Lori L.;Mintz, Jim;Gitlin, Michael J.;Subotnik, Kenneth L.;Nuechterlein, Keith H.
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Nuechterlein, Keith H.
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Chua, S. E.
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4.5
作者：
Garner, B.;Berger, G. E.;McGorry, P. D.
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McGorry, P. D.
影响因子：
6.6
作者：
Ascher-Svanum, Haya;Nyhuis, Allen W.;Faries, Douglas E.;Kinon, Bruce J.;Baker, Robert W.;Shekhar, Anantha
通讯作者：
Shekhar, Anantha
影响因子：
4.5
作者：
Mondelli, Valeria;Dazzan, Paola;Hepgul, Nilay;Di Forti, Marta;Aas, Monica;D'Albenzio, Alessandro;Di Nicola, Marco;Fisher, Helen;Handley, Rowena;Marques, Tiago Reis;Morgan, Craig;Navari, Serena;Taylor, Heather;Papadopoulos, Andrew;Aitchison, Katherine J.;Murray, Robin M.;Pariante, Carmine M.
通讯作者：
Pariante, Carmine M.