Gray Matter Changes in the Insular Cortex During the Course of the Schizophrenia Spectrum
Gray Matter Changes in the Insular Cortex During the Course of the Schizophrenia Spectrum
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DOI：
10.3389/fpsyt.2020.00659
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发表时间：
2020-07
影响因子：
4.7
通讯作者：
Tsutomu Takahashi;M. Kido;D. Sasabayashi;Mihoko Nakamura;A. Furuichi;Y. Takayanagi;K. Noguchi;Michio Suzuki
中科院分区：
文献类型：
--
作者：
Tsutomu Takahashi;M. Kido;D. Sasabayashi;Mihoko Nakamura;A. Furuichi;Y. Takayanagi;K. Noguchi;Michio Suzuki
据报道，在精神分裂症（Sz）的早期阶段，岛叶皮质中的灰质逐渐减少；然而，在疾病过程中这些减少的轨迹目前仍不清楚。此外，尚未确定具有分裂型（SzTypal）特征的患者是否表现出岛叶皮质的进行性变化。这项后续磁共振成像研究检查了 23 名首发 (FE) 患者、17 名慢性 Sz 患者、14 名 SzTypal 障碍患者和 21 名健康对照者的短岛皮质和长岛皮质体积变化（平均扫描间隔 = 2.6 年）。基线比较显示，Sz 患者（尤其是慢性组）的双侧岛叶皮质体积小于 SzTypal 患者和健康对照。随着时间的推移，FESz 患者的岛叶皮质灰质减少量（左：-3.4%/年；右：-2.9%/年）比健康对照者（两个半球-0.1%/年）显着更大，而没有亚区域或抗精神病药物的影响，而慢性 Sz（左：-1.5%/年；右：-1.6%/年）和 SzTypal（左：0.5%/年；右：-1.6%/年）。右：−0.6%/年）患者没有。 FE 期间右侧岛叶皮质的主动萎缩与 Sz 组阳性症状改善较少相关，而慢性期左侧岛叶皮质的轻度萎缩与随访期间阴性症状的严重程度相关。目前的结果支持岛皮质的动态体积变化是所检查的谱系疾病中明显的 Sz 所特有的，并且它们在症状学中的程度和作用似乎在不同的疾病阶段有所不同。
Progressive gray matter reductions in the insular cortex have been reported in the early phases of schizophrenia (Sz); however, the trajectory of these reductions during the course of the illness currently remains unclear. Furthermore, it has not yet been established whether patients with schizotypal (SzTypal) features exhibit progressive changes in the insular cortex. This follow-up magnetic resonance imaging study examined volume changes in the short and long insular cortices (mean inter-scan interval = 2.6 years) of 23 first-episode (FE) and 17 chronic patients with Sz, 14 with SzTypal disorder, and 21 healthy controls. Baseline comparisons revealed smaller insular cortex volumes bilaterally in Sz patients (particularly in the chronic group) than in SzTypal patients and healthy controls. FESz patients showed significantly larger gray matter reductions in the insular cortex over time (left: −3.4%/year; right: −2.9%/year) than those in healthy controls (−0.1%/year for both hemispheres) without the effect of subregion or antipsychotic medication, whereas chronic Sz (left: −1.5%/year; right: −1.6%/year) and SzTypal (left: 0.5%/year; right: −0.6%/year) patients did not. Active atrophy of the right insular cortex during FE correlated with fewer improvements in positive symptoms in the Sz groups, while mild atrophy of the left insular cortex during the chronic phase was associated with the severity of negative symptoms in the follow-up period. The present results support dynamic volumetric changes in the insular cortex being specific to overt Sz among the spectrum disorders examined and their degree and role in symptomatology appear to differ across the illness stages.