Brain structure in people at ultra-high risk of psychosis, patients with first-episode schizophrenia, and healthy controls: a VBM study
Brain structure in people at ultra-high risk of psychosis, patients with first-episode schizophrenia, and healthy controls: a VBM study
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DOI：
10.1016/j.schres.2014.10.041
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发表时间：
2015-02-01
影响因子：
4.5
通讯作者：
Smesny, Stefan
中科院分区：
文献类型：
--
作者：
Nenadic, Igor;Dietzek, Maren;Smesny, Stefan
精神分裂症的早期干预研究表明，大脑结构的改变可能存在于患精神病的高危人群中。这些变化的区域效应的异质性，这是建立在精神分裂症，但是，尚未探讨前驱或高危人群。我们使用高分辨率MRI和基于体素的形态测定法（VBM 8）分析了43名精神病超高风险受试者（符合ARMS标准，通过CAARMS访谈确定），24名首次服用抗精神病药物的首发精神分裂症患者和49名健康对照（年龄和性别匹配的组）的灰质差异。与健康对照组相比，首发精神分裂症患者左前额叶、颞叶、右顶叶和左颞叶皮质的区域性灰质减少，而高危组显示右中颞叶和左前额叶皮质减少。当将具有遗传风险的超高风险组与具有减弱的精神病症状的超高风险组进行划分时，前者显示出左前额叶、右尾状核以及较小的右海马和杏仁核减少，而后者亚组显示出右中颞叶皮质减少（每一个都与健康对照组相比）。我们在临床精神病高危人群中的研究结果表明，根据亚组和背景风险升高，大脑结构变化的变异性，这表明额叶和可能也海马/杏仁核的变化，在个人的遗传易感性。脑结构变化的异质性（如精神分裂症中所见）即使在精神病潜在发作之前的高风险阶段也很明显。(C)2014年爱思唯尔B。V.保留所有权利。
Early intervention research in schizophrenia has suggested that brain structural alterations might be present in subjects at high risk of developing psychosis. The heterogeneity of regional effects of these changes, which is established in schizophrenia, however, has not been explored in prodromal or high-risk populations. We used high-resolution MRI and voxel-based morphometry (VBM8) to analyze grey matter differences in 43 ultra highrisk subjects for psychosis (meeting ARMS criteria, identified through CAARMS interviews), 24 antipsychotic-naive first-episode schizophrenia patients and 49 healthy controls (groups matched for age and gender). Compared to healthy controls, resp., first-episode schizophrenia patients had reduced regional grey matter in left prefrontal, insula, right parietal and left temporal cortices, while the high-risk group showed reductions in right middle temporal and left anterior frontal cortices. When dividing the ultra-high-risk group in those with a genetic risk vs. those with attenuated psychotic symptoms, the former showed left anterior frontal, right caudate, as well as a smaller right hippocampus, and amygdala reduction, while the latter subgroup showed right middle temporal cortical reductions (each compared to healthy controls). Our findings in a clinical psychosis high-risk cohort demonstrate variability of brain structural changes according to subgroup and background of elevated risk, suggesting frontal and possibly also hippocampal/amygdala changes in individuals with genetic susceptibility. Heterogeneity of structural brain changes (as seen in schizophrenia) appears evident even at high-risk stage, prior to potential onset of psychosis. (C) 2014 Elsevier B. V. All rights reserved.