Microstructural Changes in Higher-Order Nuclei of the Thalamus in Patients With First-Episode Psychosis
Microstructural Changes in Higher-Order Nuclei of the Thalamus in Patients With First-Episode Psychosis
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DOI：
10.1016/j.biopsych.2018.05.019
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发表时间：
2019-01-01
影响因子：
10.6
通讯作者：
Kwon, Jun Soo
中科院分区：
文献类型：
--
作者：
Cho, Kang Ik K.;Kwak, Yoo Bin;Kwon, Jun Soo
背景技术背景：丘脑的破坏，如体积，形状和皮质连接，被认为是精神分裂症的重要病理生理机制。然而，很少有证据表明，在丘脑的核特异性结构的改变，在早期精神病，主要是因为传统的结构成像在识别丘脑nucleus.METHODS方法的局限性：共37例首发精神病患者和36个匹配的健康对照组进行了扩散张量成像，扩散峰度成像，T1加权磁共振成像。使用扩散张量成像进行丘脑的基于连接性的分割，并使用扩散峰度成像估计代表微结构复杂性的扩散峰度值的平均值，并在各组之间的每个丘脑核中进行比较。与眶额皮质（F-1，（70）= 8.40，p < .01）和外侧颞叶皮质（F-1，（70）= 8.46，p <0.01）在首发精神病患者中显著低于健康对照组。与眶额皮质有较强联系的丘脑区的平均峰度值与首发精神病患者的空间工作记忆准确性呈显著相关（r = 0.36，p <0.05），而在健康对照组中未观察到这些变量之间的显著相关性。所观察到的模式，减少微结构的复杂性，在核不仅突出了丘脑的参与，但也强调了在精神分裂症的早期阶段开始的病理生理学的高阶核的作用。
BACKGROUND: Disruption in the thalamus, such as volume, shape, and cortical connectivity, is regarded as an important pathophysiological mechanism in schizophrenia. However, there is little evidence of nuclei-specific structural alterations in the thalamus during early-stage psychosis, mainly because of the methodological limitations of conventional structural imaging in identifying the thalamic nuclei.METHODS: A total of 37 patients with first-episode psychosis and 36 matched healthy control subjects underwent diffusion tensor imaging, diffusion kurtosis imaging, and T1-weighted magnetic resonance imaging. Connectivity-based segmentation of the thalamus was performed using diffusion tensor imaging, and averages of the diffusion kurtosis values, which represent microstructural complexity, were estimated using diffusion kurtosis imaging and were compared in each thalamic nucleus between the groups.RESULTS: The mean kurtosis values in the thalamic regions with strong connections to the orbitofrontal cortex (F-1,(70) = 8.40, p < .01) and the lateral temporal cortex (F-1,(70) = 8.46, p < .01) were significantly reduced in patients with first-episode psychosis compared with those of the healthy control subjects. The mean kurtosis values in the thalamic region with strong connection to the orbitofrontal cortex showed a significant correlation with spatial working memory accuracy in patients with first-episode psychosis (r = .36, p < .05), whereas no significant correlation between these variables was observed in the healthy control subjects.CONCLUSIONS: The observed pattern of reduced microstructural complexity in the nuclei not only highlights the involvement of the thalamus but also emphasizes the role of the higher-order nuclei in the pathophysiology beginning in the early stage of schizophrenia.