Morphometry and gyrification in bipolar disorder and schizophrenia: A comparative MRI study
Morphometry and gyrification in bipolar disorder and schizophrenia: A comparative MRI study
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DOI：
10.1016/j.nicl.2020.102220
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发表时间：
2020-01-01
影响因子：
4.2
通讯作者：
Castelo-Branco, Miguel
中科院分区：
文献类型：
--
作者：
Madeira, Nuno;Duarte, Joao Valente;Castelo-Branco, Miguel
精神分裂症被认为是一种遗传性很高的神经发育疾病。鉴别诊断往往具有挑战性，特别是在早期阶段，即与其他精神障碍甚至情绪障碍。比如有精神病症状的双相情感障碍。区分这两种经典精神病的关键病理生理变化仍然知之甚少，目前的证据支持精神分裂症和双相情感障碍之间更多的维度而不是范畴的区分。虽然已建立的生物标志物如皮质厚度和灰质体积受到发病后变化的严重影响，因此访问早期病理的可能性有限，但脑回变被认为更具特异性地由遗传和早期发育因素决定。我们研究的目的是比较这两种典型精神障碍的经典和新的形态测量特征。我们包括20名精神分裂症患者、20名双相情感障碍患者和20名年龄和性别匹配的健康对照组。数据分析使用CAT12/SPM12应用四种形态测量的通用线性模型：脑回和皮质厚度(基于表面的形态测量)和全脑灰质/灰质体积(基于体素的形态测量-VBM)。使用年龄和性别作为协变量(以及VBM的总颅内体积)来检验组效应。基于体素的形态计量学分析显示，精神分裂症患者与对照组相比，右侧苍白球的局部灰质体积(P<；0.05，家庭纠错)有明显的影响。经多次比较校正后，白质体积和皮质厚度均无组间效应。临床标本中发现左侧边缘上回(BA40)--在BPD和SCZ患者中分别增加和减少--以及右额下回(BA47)的回旋变化，与对照组相比，SCZ组的回转减少。不同形态计量学特征的联合分析，即回旋等措施，为阐明精神障碍的不同表型提供了一种有前途的策略。不同的形态变化模式，突出特定的疾病轨迹，可能会产生神经成像衍生的生物标记物，有助于在早期阶段区分精神分裂症和双相情感障碍，例如首发精神病患者。
Schizophrenia is believed to be a neurodevelopmental disease with high heritability. Differential diagnosis is often challenging, especially in early phases, namely with other psychotic disorders or even mood disorders. such as bipolar disorder with psychotic symptoms. Key pathophysiological changes separating these two classical psychoses remain poorly understood, and current evidence favors a more dimensional than categorical differentiation between schizophrenia and bipolar disorder. While established biomarkers like cortical thickness and grey matter volume are heavily influenced by post-onset changes and thus provide limited possibility of accessing early pathologies, gyrification is assumed to be more specifically determined by genetic and early developmental factors. The aim of our study was to compare both classical and novel morphometric features in these two archetypal psychiatric disorders. We included 20 schizophrenia patients, 20 bipolar disorder patients and 20 age- and gender-matched healthy controls. Data analyses were performed with CAT12/SPM12 applying general linear models for four morphometric measures: gyrification and cortical thickness (surface-based morphometry), and whole-brain grey matter/grey matter volume (voxel-based morphometry - VBM). Group effects were tested using age and gender as covariates (and total intracranial volume for VBM). Voxel-based morphometry analysis revealed a schizophrenia vs. control group effect on regional grey matter volume (p < 0.05, familywise error correction) in the right globus pallidus. There was no group effect on white matter volume when correcting for multiple comparisons neither on cortical thickness. Gyrification changes in clinical samples were found in the left supramarginal gyrus (BA40) - increased and reduced gyrification, respectively, in BPD and SCZ patients - and in the right inferior frontal gyrus (BA47), with a reduction in gyrification of the SCZ group when compared with controls. The joint analysis of different morphometric features, namely measures such as gyrification, provides a promising strategy for the elucidation of distinct phenotypes in psychiatric disorders. Different morphological change patterns, highlighting specific disease trajectories, could potentially generate neuroimaging-derived biomarkers, helping to discriminate schizophrenia from bipolar disorder in early phases, such as first-episode psychosis patients.