Longitudinal Imaging of Patients at Clinical Risk for Psychosis.

摘要 重要的是要在精神分裂症的早期阶段进行评估，以便识别出 受影响，以便更好地了解疾病的原因并采取适当的预防措施 制定了干预措施。一个主要的研究目标是使用磁共振成像 (核磁共振)以识别大脑异常区域，这将使我们了解 精神分裂症早期进化和出现的机制。我们的团队确定了 一种有前景的成像生物标记物，使用使用Gd的高分辨率功能MRI变体 造影剂增强了海马区的基础功能，这与 精神分裂症本身，与疾病各阶段阳性精神病症状的严重程度有关 如妄想症，以及预测从前驱症状或临床高风险进展为精神病 国家在一小群人(肖贝尔，莱万多夫斯基等人)。2009年) 重要的是，到目前为止，这些发现是基于相对较小的受试者队列，27 精神分裂症患者，27名临床高危精神病患者，24名 比较对象。我们的目标是在之前发表的研究的基础上，通过扩展 对精神分裂症和临床有精神病风险的患者进行队列研究，以检验 推定标记物，包括对大脑功能和结构的纵向评估。这个 这项建议的意义是明确测试使用高分辨率fMRI变体的实用性 为了检测精神分裂症的早期阶段，测试使用低分辨率非 侵入性功能磁共振变异用于检测精神分裂症的早期阶段，并阐明两者之间的关系 发病时大脑功能异常与结构异常之间的关系。如果所提出的目标得以实现， 我们在疾病前兆阶段的诊断能力将得到增强，我们的 了解急诊精神病的病理生理学，这两者都是 制定预防性干预措施，以努力减少严重的 精神分裂症和相关的精神障碍。

Abstract It is important to evaluate schizophrenia in its early stages in order to identify brain sites that are affected, such that causes of illness may be better understood and appropriate preventive interventions developed. A major research goal has been to use magnetic resonance imaging (MRI) to identify areas of brain abnormality which would inform our knowledge as to the mechanisms underlying the early evolution and emergence of schizophrenia. Our group identified a promising imaging biomarker using a high-resolution variant of functional MRI using gadolinium contrast- increased basal function in hippocampal subregions, which was associated with schizophrenia itself, related to the severity of positive psychotic symptoms across illness stages such as delusions, and predicted progression to psychosis from a prodromal or clinical high-risk state in a small cohort (Schobel, Lewandowski et al. 2009) Importantly, these findings to date are based upon a relatively small cohort of subjects, 27 patients with schizophrenia, 27 patients who are at high clinical risk for psychosis, and 24 comparison subjects. We aim to build upon our previous published study by expanding the cohort of schizophrenia and patients at clinical risk for psychosis to test the predictive value of the putative marker, and include longitudinal assessment of brain function and structure. The significance of this proposal is to definitively test the utility of using a high-resolution fMRI variant to detect the earliest stages of schizophrenia, to test the utility of using a lower-resolution non- invasive fMRI variant to detect the earliest stages of schizophrenia, and to clarify the relationship between abnormal brain function and structure in its onset. If the proposed aims are achieved, our diagnostic capabilities in prodromal stages of disease will be enhanced as well as our understanding of the pathophysiology of emergent psychotic illness, both of which are key to developing preventative interventions in an effort to reduce the significant morbidity of schizophrenia and related psychotic disorders.