Evidence for Network-Based Cortical Thickness Reductions in Schizophrenia.
Evidence for Network-Based Cortical Thickness Reductions in Schizophrenia.
复制标题
DOI：
10.1176/appi.ajp.2019.18040380
复制
发表时间：
2019-06
期刊：
影响因子：
--
通讯作者：
C. Wannan;V. Cropley;M. Chakravarty;C. Bousman;Eleni P. Ganella;J. Bruggemann;T. Weickert;C. Weickert;I. Everall;P. McGorry;D. Velakoulis;S. Wood;C. Bartholomeusz;C. Pantelis;A. Zalesky
中科院分区：
文献类型：
--
作者：
C. Wannan;V. Cropley;M. Chakravarty;C. Bousman;Eleni P. Ganella;J. Bruggemann;T. Weickert;C. Weickert;I. Everall;P. McGorry;D. Velakoulis;S. Wood;C. Bartholomeusz;C. Pantelis;A. Zalesky
目的：精神分裂症患者大脑皮层厚度的减少在多个基因座上呈不规则分布。作者假设，皮质连接网络可以解释皮质厚度减少在皮质中的分布，特别是，这些减少的位点之间的皮质-皮质连接将异常强烈，并形成一个相互连接的网络。这一假设在三个横断面精神分裂症队列中得到了检验：首发精神病、慢性精神分裂症和难治性精神分裂症。方法对70例首发精神病患者、153例慢性精神分裂症患者和47例治疗难治性精神分裂症患者以及与之匹配的健康对照组（N=57、N=168和N=54）进行脑结构图像采集。在横跨皮质的148个区域比较患者和各自对照组的皮质厚度。用结构协方差分析对皮质区域间的结构连接强度进行量化。将皮质厚度减少的区域之间的连通性强度与5000组随机选择的区域之间的连通性强度进行比较，以确定减少的区域之间的连通性是否比偶然预期的更强。结果：在慢性精神分裂症（79个区域）和治疗抵抗性精神分裂症（106个区域）组中发现了显著的（错误发现率纠正）和广泛的皮质厚度减少，在首发精神病组（34个区域）中发现了更有限的减少。额叶区、颞叶区、扣带区和岛叶区皮质厚度减少的影响最大。在所有队列中，与随机选择的区域相比，患者和健康对照组的皮质厚度减少区域之间的结构协方差显著增加。结论脑网络结构可以解释精神分裂症患者皮层厚度减少的不规则地形分布。这一发现在三个不同的精神分裂症队列中得到了重复，表明这种效果是强大的，与疾病阶段无关。
OBJECTIVE Cortical thickness reductions in schizophrenia are irregularly distributed across multiple loci. The authors hypothesized that cortical connectivity networks would explain the distribution of cortical thickness reductions across the cortex, and, specifically, that cortico-cortical connectivity between loci with these reductions would be exceptionally strong and form an interconnected network. This hypothesis was tested in three cross-sectional schizophrenia cohorts: first-episode psychosis, chronic schizophrenia, and treatment-resistant schizophrenia. METHODS Structural brain images were acquired for 70 patients with first-episode psychosis, 153 patients with chronic schizophrenia, and 47 patients with treatment-resistant schizophrenia and in matching healthy control groups (N=57, N=168, and N=54, respectively). Cortical thickness was compared between the patient and respective control groups at 148 regions spanning the cortex. Structural connectivity strength between pairs of cortical regions was quantified with structural covariance analysis. Connectivity strength between regions with cortical thickness reductions was compared with connectivity strength between 5,000 sets of randomly chosen regions to establish whether regions with reductions were interconnected more strongly than would be expected by chance. RESULTS Significant (false discovery rate corrected) and widespread cortical thickness reductions were found in the chronic schizophrenia (79 regions) and treatment-resistant schizophrenia (106 regions) groups, with more circumscribed reductions in the first-episode psychosis group (34 regions). Cortical thickness reductions with the largest effect sizes were found in frontal, temporal, cingulate, and insular regions. In all cohorts, both the patient and healthy control groups showed significantly increased structural covariance between regions with cortical thickness reductions compared with randomly selected regions. CONCLUSIONS Brain network architecture can explain the irregular topographic distribution of cortical thickness reductions in schizophrenia. This finding, replicated in three distinct schizophrenia cohorts, suggests that the effect is robust and independent of illness stage.