Role of glia in prefrontal white matter abnormalities in first episode psychosis or mania detected by diffusion tensor spectroscopy.
Role of glia in prefrontal white matter abnormalities in first episode psychosis or mania detected by diffusion tensor spectroscopy.
复制标题
通过扩散张量光谱检测神经胶质细胞在首发精神病或躁狂症中前额白质异常中的作用。
DOI：
10.1016/j.schres.2019.05.018
复制
发表时间：
2019
影响因子：
4.5
通讯作者：
Öngür,Dost
中科院分区：
文献类型：
--
作者：
Lewandowski,KathrynE;Du,Fei;Fan,Xiaoying;Chen,Xi;Huynh,Polly;Öngür,Dost
背景白质（WM）异常是包括精神分裂症（SZ）和双相情感障碍（BD）在内的精神障碍患者最常见的神经影像学表现之一，并且可能是病理生理学的核心。很少有研究直接比较 SZ 和 BD 患者在疾病首次发作时的 WM 异常，迄今为止还没有研究尝试使用补充 MRI 技术来分离轴突和髓磷脂的异常。方法我们使用弥散张量光谱组合来测量 NAA、肌酸 (Cr) 和胆碱，检查了发病第一年内 SZ (n = 19) 或 BD (n = 16) 的年轻人以及健康对照 (n = 22) 的 WM 异常(Cho) 和磁化传递比 (MTR)。 MTR 反映髓磷脂含量，NAA 扩散是神经元特异性的，Cr 和 Cho 扩散反映神经元和神经胶质信号。结果我们发现，与对照组相比，任一患者组的 MTR 或 NAA ADC 没有差异，但 SZ 患者的 Cr 和 Cho 扩散显着升高，BD 患者的 Cho 扩散升高。在没有 NAA 扩散异常的情况下 Cr 和 Cho 扩散的升高表明神经胶质细胞中出现了异常信号。结论神经胶质细胞异常在精神病首次发作时就存在并可检测到，而轴突和髓磷脂的主要异常则不然。在病程早期检查这些神经生物学标志物可以阐明 WM 这些不同方面的神经进展性质及其与早期临床表型的关联。
BackgroundWhite matter (WM) abnormalities are amongst the most commonly described neuroimaging findings in patients with psychotic disorders including schizophrenia (SZ) and bipolar disorder (BD), and may be central to pathophysiology. Few studies have directly compared WM abnormalities in patients with SZ and BD in the first episode of illness, and no studies to date have attempted to separate abnormalities of axon and myelin using complementary MRI techniques.MethodsWe examined WM abnormalities in young adults with SZ (n= 19) or BD (n= 16) within the first year of illness onset, and healthy controls (n= 22) using a combination of diffusion tensor spectroscopy to measure NAA, creatine (Cr), and choline (Cho), and magnetization transfer ratio (MTR). MTR reflects myelin content, NAA diffusion is neuron specific, and Cr and Cho diffusion reflect both neuron and glial signal.ResultsWe found no differences in MTR or NAA ADC in either patient group compared to controls, but significant elevations of both Cr and Cho diffusion in patients with SZ, and elevations of Cho diffusion in patients with BD. Elevations in Cr and Cho diffusion in the absence of NAA diffusion abnormalities indicate that the aberrant signal arises in glia.ConclusionsGlial abnormalities were present and detectable by the first episode of psychosis, whereas major abnormalities in axon and myelin were not. Examination of these neurobiological markers early in the course of illness may clarify the neuroprogressive nature of these distinct aspects of WM, and their associations with early clinical phenotypes.