Trajectory of Brain Structure and Function before and after the Onset of Psychosis: a Longitudinal Multicentre Study

精神分裂症等精神障碍是致残的，也是相对常见的疾病。它们通常开始于成年早期，是慢性疾病。治疗可以部分减轻一些症状，但不能治愈。这些障碍之前都有一种“危险精神状态”（ARMS）。这个州的人有30%患精神病的风险。然而，目前还不可能预测哪些患有ARMS的个体会继续发展为精神病，哪些不会。我的研究目的是测试用核磁共振成像（MRI）扫描测量患有ARMS的人的大脑结构和功能是否可以帮助临床医生预测谁以后会生病。为了做到这一点，我将把从欧洲和澳大利亚的几个不同研究中心收集的大量扫描结果放在一起。参加研究的ARMS患者将在他们第一次联系支持诊所时进行扫描，然后在3个月，12个月和24个月后再次进行扫描。我将使用扫描中的信息来测试大脑随时间变化的方式，在后来发展为精神病的人和没有患精神病的人身上是否有所不同。有证据表明，大脑中被称为海马体、脑岛和侧脑室的特定区域的体积在接近精神疾病开始的时间点时发生了变化。然而，目前尚不清楚这些变化发生的确切时间，以及它们是发生在精神病开始之前还是之后。通过核磁共振扫描，我将能够准确地发现这些变化发生的时间。一种流行的精神分裂症理论认为，大脑中一个被称为海马体的区域变得异常活跃，然后导致大脑中另一个被称为纹状体的区域出现问题，纹状体在精神病症状中很重要。我将用核磁共振扫描来测试海马体和纹状体的活动。

Psychotic disorders such as schizophrenia are disabling and relatively common conditions. They usually begin in early adulthood, and are chronic illnesses. Treatment can partially reduce some of the symptoms, but is not curative. These disorders are preceded by an 'at risk mental state' (ARMS). People in this state have a 30% risk of developing psychosis. However, at present, it is not possible to predict which individual with an ARMS will go on to develop psychosis and which will not. The aim of my study is to test whether measuring the structure and function of the brain with Magnetic Resonance Imaging (MRI) scanning in people with an ARMS can help clinicians to predict who will later become ill. In order to do this, I will put together a large number of scans collected from several different research centres in Europe and Australia. People with an ARMS who take part in the study will be scanned when they first contact support clinics, and then again after 3 months, 12 months and 24 months. I will use the information in the scans to test whether the way the brain changes over time is different in people who will later develop psychosis compared to people who do not. There is evidence to suggest that specific regions of the brain called the hippocampus, insula and lateral ventricles change in volume close to the time-point that a psychotic illness starts. However it is not known exactly when these changes occur and if they happen before or after the beginning of psychosis. From the MRI scans I will be able to discover exactly when these changes occur. One popular theory of schizophrenia proposes that a region of the brain called the hippocampus becomes abnormally active and then causes problems in regulating another region of the brain called the striatum which is important in symptoms of psychosis. I will test this theory by using the MRI scans to measure the activity of the hippocampus compared to activity in the striatum.