Distinct pattern of brain structural deficits in subsyndromes of schizophrenia delineated by psychopathology
Distinct pattern of brain structural deficits in subsyndromes of schizophrenia delineated by psychopathology
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DOI：
10.1016/j.neuroimage.2009.10.014
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发表时间：
2010-01-15
期刊：
影响因子：
5.7
通讯作者：
Gaser, Christian
中科院分区：
文献类型：
--
作者：
Nenadic, Igor;Sauer, Heinrich;Gaser, Christian
大脑形态变化是精神分裂症中研究最为深入的潜在内表型之一，与遗传易感性和疾病表型的表达相关。然而，个体之间存在相当大的异质性，这使得将其用作疾病特异性标志物变得困难。在这项研究中，我们考虑疾病表型的精神病理学变异性来描绘精神分裂症的亚综合征，将它们与不同的大脑形态模式联系起来，并使用分类方法来测试所实现区分的特异性。我们首先应用基于体素的形态测量学（VBM）来比较99名符合《精神疾病诊断与统计手册》第四版（DSM - IV）精神分裂症诊断标准（精神病理学稳定且正在使用抗精神病药物）的患者和113名匹配的健康对照，然后根据精神病理学模式在患者队列中划分出三个亚组，并比较灰质异常的不同模式。最后，我们测试了将任何个体的磁共振成像（MRI）扫描准确归类到对照组或三个患者亚组中任意一组的准确性。虽然VBM分析显示大脑结构缺陷主要在前额叶区域存在重叠，但紊乱型亚综合征在内侧颞叶和小脑区域表现出更严重的缺陷，偏执/幻觉型亚综合征在颞上回皮质有额外的影响，而阴性症状型亚综合征在丘脑表现出更严重的缺陷。使用一种自动算法，我们将任何给定的扫描归类到其中一个亚组的准确率达到了95.8%。精神病理学模式是减少精神分裂症大脑形态内表型异质性的有意义的参数。（C）2009爱思唯尔公司。保留所有权利。
Brain morphological changes are among the best-studied potential endophenotypes in schizophrenia and linked to genetic liability and expression of disease phenotype. Yet, there is considerable heterogeneity across individual subjects making its use as a disease-specific marker difficult. In this study we consider psychopathological variability of disease phenotype to delineate subsyndromes of schizophrenia, link them to distinct brain morphological patterns, and use a classification approach to test specificity of achieved discrimination. We first applied voxel-based morphometry (VBM) to compare 99 patients with DSM-IV schizophrenia (stable psychopathology and antipsychotic medication) with 113 matched healthy controls, then delineated three subgroups within the patient cohort based on psycho pathology pattern and compared differential patterns of grey matter abnormalities. Finally, we tested accuracy of assigning any individual MRI scan to either the control group or any of the three patient subgroups. While VBM analysis showed overlap of brain structural deficits mostly in prefrontal areas, the disorganised subsyndrome showed stronger deficits in medial temporal and cerebellar regions, the paranoid/hallucinatory subsyndrome showed additional effects in the superior temporal cortex, and the negative subsyndrome showed stronger deficits in the thalamus. Using an automated algorithm, we achieved 95.8% accuracy classifying any given scan to one of the subgroups. Patterns of psychopathology are meaningful parameters in reducing heterogeneity of brain morphological endophenotypes in schizophrenia. (C) 2009 Elsevier Inc. All rights reserved.