Brain structure, function, and neurochemistry in schizophrenia and bipolar disorder-a systematic review of the magnetic resonance neuroimaging literature.
Brain structure, function, and neurochemistry in schizophrenia and bipolar disorder-a systematic review of the magnetic resonance neuroimaging literature.
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DOI：
10.1038/s41537-017-0013-9
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发表时间：
2017
影响因子：
5.4
通讯作者：
Lahti AC
中科院分区：
文献类型：
--
作者：
Birur B;Kraguljac NV;Shelton RC;Lahti AC
自从Emil Kraepelin将内源性精神病概念化为早发性痴呆和躁狂抑郁症以来，原发性精神障碍和原发性情感障碍之间的分离一直备受争议。我们对精神分裂症和双相情感障碍磁共振成像研究的病例对照研究进行了系统回顾。在PubMed中对2005年1月至2016年12月期间发表的研究进行了文献检索，认为50项结构研究、29项功能研究、7项磁共振波谱研究和8项影像学和遗传学联合研究符合系统综述的条件。结构神经影像学研究表明，白色物质完整性缺陷在所有疾病中是一致的，而灰质减少在精神分裂症中比双相情感障碍更普遍。皮质灰质的光谱学研究报告的证据，减少神经元的完整性在这两种疾病。功能性神经影像学研究通常报告了健康对照组和精神病患者的大脑网络的相似功能结构，但发现疾病之间任务相关激活和静息状态连接的变化程度不同。非常有限的成像遗传学文献表明精神病风险基因与大脑结构之间存在关系，并且可能存在基因与诊断相互作用对功能成像标记物的影响。虽然现有的文献表明，精神分裂症和双相情感障碍中存在一些共同的和一些不同的神经标志物，但必须在首次用药的患者中进行大型，精心设计的多模态神经影像学研究，这些研究将在他们的疾病过程中进行纵向随访，以促进我们对疾病机制的理解。
Since Emil Kraepelin’s conceptualization of endogenous psychoses as dementia praecox and manic depression, the separation between primary psychotic disorders and primary affective disorders has been much debated. We conducted a systematic review of case–control studies contrasting magnetic resonance imaging studies in schizophrenia and bipolar disorder. A literature search in PubMed of studies published between January 2005 and December 2016 was conducted, and 50 structural, 29 functional, 7 magnetic resonance spectroscopy, and 8 combined imaging and genetic studies were deemed eligible for systematic review. Structural neuroimaging studies suggest white matter integrity deficits that are consistent across the illnesses, while gray matter reductions appear more widespread in schizophrenia compared to bipolar disorder. Spectroscopy studies in cortical gray matter report evidence of decreased neuronal integrity in both disorders. Functional neuroimaging studies typically report similar functional architecture of brain networks in healthy controls and patients across the psychosis spectrum, but find differential extent of alterations in task related activation and resting state connectivity between illnesses. The very limited imaging-genetic literature suggests a relationship between psychosis risk genes and brain structure, and possible gene by diagnosis interaction effects on functional imaging markers. While the existing literature suggests some shared and some distinct neural markers in schizophrenia and bipolar disorder, it will be imperative to conduct large, well designed, multi-modal neuroimaging studies in medication-naïve first episode patients that will be followed longitudinally over the course of their illness in an effort to advance our understanding of disease mechanisms.