Structural brain abnormalities in first-episode psychosis: differences between affective psychoses and schizophrenia and relationship to clinical outcome
Structural brain abnormalities in first-episode psychosis: differences between affective psychoses and schizophrenia and relationship to clinical outcome
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DOI：
10.1111/j.1399-5618.2011.00953.x
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发表时间：
2011-08-01
影响因子：
5.4
通讯作者：
McGuire, Philip
中科院分区：
文献类型：
--
作者：
de Castro-Manglano, Pilar;Mechelli, Andrea;McGuire, Philip
目的：一些研究描述了首发精神病患者的脑体积异常。在精神分裂症和情感性精神病患者中，这些差异有多大，或者与随后的临床结果有关，目前尚不清楚。我们检查了首发精神病的年轻患者的体积磁共振成像(MRI)异常，并将精神分裂症患者和情感性精神病患者的这些体积异常进行了比较。然后我们评估整个样本中的基线MRI异常是否可以预测后续的临床结果。方法：使用1.5T扫描仪对28名首发精神病青少年患者和20名年龄匹配的健康志愿者进行扫描。采用基于体素的形态计量学(VBM)对MRI数据进行处理和分析。我们在初始扫描三年后评估临床结果。结果：患者额叶、岛叶、顶叶和小脑皮质灰质(GM)体积小于对照组。情感性精神病患者右侧后扣带回的GM体积大于对照组和精神分裂症患者，而左侧小脑和脑岛的GM体积较小。在整个样本中，右侧海马区Gm体积较小与三年随访的临床结果较差有关。结论：首次出现情感性精神病和精神分裂症的年轻人存在明显的脑体积异常，但这两组患者之间也存在显著差异。首次发病后的临床结果可能与发病时体积异常的严重程度有关。
Objectives: Several studies have described volumetric brain abnormalities in first-episode psychosis. The extent to which these differ in patients with schizophrenia and affective psychoses, or are related to subsequent clinical outcome, is unclear. We examined volumetric magnetic resonance imaging (MRI) abnormalities in young patients with a first episode of psychosis, and compared these volumetric abnormalities in patients with schizophrenia versus affective psychosis. We then assessed whether baseline MRI abnormalities in the entire sample predicted subsequent clinical outcome.Methods: A total of 28 adolescent patients with first-episode psychosis and 20 age-matched healthy volunteers were scanned using a 1.5 T scanner. MRI data were processed and analysed using voxel-based morphometry (VBM). We assessed clinical outcome three years after the initial scan.Results: Patients had smaller grey matter (GM) volumes than controls in frontal, insular, parietal, and cerebellar cortex. Patients with an affective psychosis had greater GM volume in the right posterior cingulate than both controls and patients with schizophrenia, but less GM volume in the left cerebellum and insula. In the sample as a whole, smaller right hippocampus GM volume was associated with poor clinical outcome at three-year follow-up.Conclusions: Volumetric brain abnormalities are evident in young adults presenting with a first episode of both affective psychoses and schizophrenia, but there are also significant differences between these two patient groups. Clinical outcome after the first episode may be related to the severity of volumetric abnormalities at presentation.