Personality disorder symptomatology is associated with anomalies in striatal and prefrontal morphology.
Personality disorder symptomatology is associated with anomalies in striatal and prefrontal morphology.
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DOI：
10.3389/fnhum.2015.00472
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发表时间：
2015
影响因子：
2.9
通讯作者：
Chakravarty MM
中科院分区：
文献类型：
--
作者：
Payer DE;Park MT;Kish SJ;Kolla NJ;Lerch JP;Boileau I;Chakravarty MM
人格障碍症状学(PD-SX)可导致个人痛苦和人际功能受损，即使在没有临床诊断的情况下也是如此，并且经常与药物使用、情绪和焦虑症等精神障碍并存；然而，它们经常得不到治疗，临床研究中也没有考虑到这些问题。为了研究PD-SX的脑形态相关性，我们测量了皮质下的体积和形状，以及皮质厚度/表面积，基于结构磁共振图像。我们调查了37名报告PD-SX超过DSM-IV Axis-II筛查阈值的受试者，以及35名年龄、性别和吸烟状况匹配的对照组受试者。然后，报告PD-SX的受试者被分成基于症状的分组：N=20进入B组(报告反社会性、边缘性、戏剧性或自恋性PD-SX)，N=28进入C组(报告强迫型、逃避性或依赖型PD-SX)；N=11名受试者报告来自两个组的PD-SX，没有报告A组(偏执、分裂样或分裂型)PD-SX。与对照组相比，C簇PD-SX位于尾状尾部的纹状体表面积较大，腹侧纹状体体积较小，右侧前额叶皮质厚度较大。B簇和C簇PD-SX组也显示出更大的后尾状体积和眼眶前额表面积异常的趋势，但这些发现在多次比较后没有得到纠正。结果表明，形态异常可能是导致集群C PD-SX的原因之一。此外，这些观察结果与物质使用障碍的观察结果相似，表明在解释经常合并的精神障碍的研究结果时，考虑PD-SX的重要性。
Personality disorder symptomatology (PD-Sx) can result in personal distress and impaired interpersonal functioning, even in the absence of a clinical diagnosis, and is frequently comorbid with psychiatric disorders such as substance use, mood, and anxiety disorders; however, they often remain untreated, and are not taken into account in clinical studies. To investigate brain morphological correlates of PD-Sx, we measured subcortical volume and shape, and cortical thickness/surface area, based on structural magnetic resonance images. We investigated 37 subjects who reported PD-Sx exceeding DSM-IV Axis-II screening thresholds, and 35 age, sex, and smoking status-matched control subjects. Subjects reporting PD-Sx were then grouped into symptom-based clusters: N = 20 into Cluster B (reporting Antisocial, Borderline, Histrionic, or Narcissistic PD-Sx) and N = 28 into Cluster C (reporting Obsessive–Compulsive, Avoidant, or Dependent PD-Sx); N = 11 subjects reported PD-Sx from both clusters, and none reported Cluster A (Paranoid, Schizoid, or Schizotypal) PD-Sx. Compared to control, Cluster C PD-Sx was associated with greater striatal surface area localized to the caudate tail, smaller ventral striatum volumes, and greater cortical thickness in right prefrontal cortex. Both Cluster B and C PD-Sx groups also showed trends toward greater posterior caudate volumes and orbitofrontal surface area anomalies, but these findings did not survive correction for multiple comparisons. The results point to morphological abnormalities that could contribute to Cluster C PD-Sx. In addition, the observations parallel those in substance use disorders, pointing to the importance of considering PD-Sx when interpreting findings in often-comorbid psychiatric disorders.