Association of grey matter volume deviation with insight impairment in first-episode affective and non-affective psychosis
Association of grey matter volume deviation with insight impairment in first-episode affective and non-affective psychosis
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DOI：
10.1007/s00406-012-0333-8
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发表时间：
2013-03-01
影响因子：
4.7
通讯作者：
McDonald, Colm
中科院分区：
文献类型：
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作者：
McFarland, John;Cannon, Dara M.;McDonald, Colm
精神病性自知力受损的神经生物学相关性仍不确定，并且可能受到疾病进展和药物使用等因素的影响。我们的研究由两个独立的实验组成。在第一个实验中，我们检查了 32 名首发精神病患者的洞察力测量与区域脑容量之间的关联。在第二个实验中，我们观察了 30 名慢性精神分裂症患者的类似关联。使用量表获得症状意识和症状归因的详细测量，以评估精神障碍的不意识。使用统计非参数映射获取和分析 MRI 扫描，以对灰质图进行基于体素的分析。回归模型用于评估首发精神病和慢性精神分裂症实验中洞察力和灰质体积之间的关系，同时控制潜在的混杂因素。在首发精神病患者中，症状错误归因与左右尾状核、右侧丘脑、左侧岛叶、壳核和小脑的灰质增加有关。在慢性精神分裂症研究中，区域灰质体积与洞察力测量之间没有显着关联。这些发现表明，皮层下和额颞叶区域内的神经塑性变化与个体在精神病首次发作期间的洞察力受损有关。
The neurobiological correlates of impaired insight in psychotic illness remain uncertain and may be confounded by factors such as illness progression and medication use. Our study consisted of two separate experiments. In the first experiment, we examined the association between measures of insight and regional brain volume in thirty-two patients with first-episode psychosis. In the second experiment, we looked at similar associations in thirty individuals with chronic schizophrenia. Detailed measures of symptom awareness and symptom attribution were obtained using the Scale to assess Unawareness of Mental Disorder. MRI scans were acquired and analysed using Statistical Non-Parametric Mapping for voxel-based analyses of grey matter maps. Regression models were used to assess the relationship between insight and grey matter volume in both the first-episode psychosis and the chronic schizophrenia experiments whilst controlling for potential confounds. In first-episode psychosis patients, symptom misattribution was associated with increased grey matter in the right and left caudate, right thalamus, left insula, putamen and cerebellum. In the chronic schizophrenia study, there were no significant associations between regional grey matter volume and measures of insight. These findings suggest that neuroplastic changes within subcortical and frontotemporal regions are associated with impaired insight in individuals during their first episode of psychosis.