Identifying Imaging Biomarkers of Schizophrenia-Risk in Kenya

摘要 精神分裂症(SZ)的早期治疗与更好的结果有关，并在 疾病的发生为预防带来希望。这在撒哈拉以南非洲尤其相关，那里的金融和 用于管理精神病的卫生保健资源极其有限。我们目前的建议旨在 将尖端精神神经成像研究引入肯尼亚，并涉及多模式成像 青少年和青壮年处于临床高危(CHR)的发展SZ和其他精神障碍。 评估年轻人的临床风险症状显著提高了有针对性地预防 全面的精神障碍。通过我们之前的工作，我们率先在 非洲，并且仍然是非洲大陆唯一积极调查这一危险人群的群体。我们现有的研究 在肯尼亚的研究表明，一些行为表型可能有助于更好地识别那些 过渡到深圳。发展中国家的研究也确定了潜在的神经成像预测因素 精神疾病的进展，但这类研究以前从未在非洲人群中进行过。在美国 在美国，我们小组在图像分析方面有长期的经验，涉及大脑结构和 深圳和其他群体的连通性。在目前的研究中，我们将使用我们的华盛顿大学人类 Connectome Project关于成像数据的处理管道提供了一个独特的机会来表征 一个种族相同的非洲队列中早期精神病的病理基础。在我们现有的基础上构建 合作，我们的建议在肯尼亚开创了一种新的精神病学研究模式，并为未来建设能力 该国的神经成像研究(目标1)。我们将学习大脑形态计量学，以及结构和 慢性阻塞性肺疾病组和健康对照组的功能连接(目标2)。此外，我们还将调查 脑部发现的纵向稳定性和临床变化的潜在预测因素(目标3)。这将扩大我们的 了解精神障碍中的脑神经生物学，为将这一知识转化为 表明预防措施。我们的建议在肯尼亚开创了一种新的精神病学研究模式，并建立了能力 用于未来在该国进行的神经成像研究。

ABSTRACT Early treatment of schizophrenia (SZ) is linked to better outcomes, and accurately identifying individuals before illness onset holds promise for prevention. This is especially relevant in sub-Saharan Africa, where financial and health care resources for managing psychotic disorders are extremely limited. Our current proposal aims to introduce cutting-edge psychiatric neuroimaging research to Kenya, and involves multi-modal imaging in adolescents and young adults at clinical high risk (CHR) of developing SZ and other psychotic disorders. Assessing clinical risk symptoms in youth has significantly advanced the possibility of indicated prevention of a full-blown psychotic disorder. Through our previous work, we pioneered prodromal behavioral assessments in Africa, and remain the only group in the continent actively investigating this risk population. Our existing studies in Kenya have suggested some behavioral phenotypes may help better identify those individuals who would transition to SZ. Studies in developing countries have also identified potential neuroimaging predictors of psychosis progression, but such studies have not been previously conducted in African populations. In the United States, our group has had longstanding experience with image analyses involving brain structure and connectivity in SZ and other groups. In the current study, we will use our Washington University Human Connectome Project processing pipeline on imaging data to provide a unique opportunity to characterize the pathological substrates of early psychosis in a racially homogenous African cohort. Building on our existing collaborations, our proposal pioneers a new psychiatric research modality in Kenya and builds capacity for future neuroimaging studies in the country (Aim 1). We will study brain morphometry, as well as structural and functional connectivity in CHR and healthy control groups (Aim 2). Additionally, we will investigate the longitudinal stability of brain findings and potential predictors of clinical change (Aim 3). This would expand our understanding of brain neurobiology in psychotic disorders, paving the path for translation of this knowledge to indicated prevention. Our proposal pioneers a new psychiatric research modality in Kenya, and builds capacity for future neuroimaging studies in the country.