Hippocampal Hyperconnectivity to the Visual Cortex Predicts Treatment Response.
Hippocampal Hyperconnectivity to the Visual Cortex Predicts Treatment Response.
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DOI：
10.1093/schbul/sbac213
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发表时间：
2023-02
影响因子：
6.6
通讯作者：
Eric A. Nelson;N. Kraguljac;J. Maximo;W. Armstrong;A. Lahti
中科院分区：
文献类型：
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作者：
Eric A. Nelson;N. Kraguljac;J. Maximo;W. Armstrong;A. Lahti
背景越来越多的证据表明精神病谱系障碍中的海马体功能障碍，包括功能连接性改变。证据还表明，抗精神病药物可以调节海马体功能障碍。该项目的目标是在两组精神病谱系障碍患者中确定预测抗精神病药物治疗反应的海马区连接模式，一组药物治疗天真，另一组未用药。假设我们假设我们将在两个队列中确定可靠的海马区连接模式，这些模式可以预测治疗反应，并且药物将在治疗6周后调节异常的海马区连接。研究设计我们采用前瞻性设计，在两个队列中，在抗精神病药物治疗前和利培酮治疗6周后收集静息状态的fMRI扫描。我们招募了44名药物治疗的首发精神病患者(FEP)和39名未用药的精神分裂症患者(SZ)。研究结果在两组患者中，我们观察到一个相似的模式，即更大的海马区与枕叶皮质区域的连通性预测治疗反应。在未用药的SZ患者中，额叶极、眶前皮质、穹隆下区和内侧前额叶皮质的低海马区连接性对治疗反应有预测作用，但在药物未用药的队列中则不然。此外，随着治疗的进行，海马区与视皮层的连接性更大地减少，这与更好的临床反应有关。结论我们的结果表明，海马区和枕叶皮质之间更强的连通性不仅预示着更好的治疗反应，而且抗精神病药物通过减少过度连通性而具有调节作用。
BACKGROUND Converging lines of evidence point to hippocampal dysfunction in psychosis spectrum disorders, including altered functional connectivity. Evidence also suggests that antipsychotic medications can modulate hippocampal dysfunction. The goal of this project was to identify patterns of hippocampal connectivity predictive of response to antipsychotic treatment in 2 cohorts of patients with a psychosis spectrum disorder, one medication-naïve and the other one unmedicated. HYPOTHESIS We hypothesized that we would identify reliable patterns of hippocampal connectivity in the 2 cohorts that were predictive of treatment response and that medications would modulate abnormal hippocampal connectivity after 6 weeks of treatment. STUDY DESIGN We used a prospective design to collect resting-state fMRI scans prior to antipsychotic treatment and after 6 weeks of treatment with risperidone, a commonly used antipsychotic medication, in both cohorts. We enrolled 44 medication-naïve first-episode psychosis patients (FEP) and 39 unmedicated patients with schizophrenia (SZ). STUDY RESULTS In both patient cohorts, we observed a similar pattern where greater hippocampal connectivity to regions of the occipital cortex was predictive of treatment response. Lower hippocampal connectivity of the frontal pole, orbitofrontal cortex, subcallosal area, and medial prefrontal cortex was predictive of treatment response in unmedicated SZ, but not in the medication-naïve cohort. Furthermore, greater reduction in hippocampal connectivity to the visual cortex with treatment was associated with better clinical response. CONCLUSIONS Our results suggest that greater connectivity between the hippocampus and occipital cortex is not only predictive of better treatment response, but that antipsychotic medications have a modulatory effect by reducing hyperconnectivity.