早期精神病的神经影像学改变和复发。

IF 4.1 2区 医学 Q2 NEUROSCIENCES Journal of Psychiatry & Neuroscience Pub Date : 2024-04-03 Print Date: 2024-01-01 DOI:10.1503/jpn.230115
Marina Mihaljevic, Anisha Nagpal, Semra Etyemez, Zui Narita, Anna Ross, Rebecca Schaub, Nicola G Cascella, Jennifer M Coughlin, Gerald Nestadt, Frederik C Nucifora, Thomas W Sedlak, Vince D Calhoun, Andreia V Faria, Kun Yang, Akira Sawa
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引用次数: 0

摘要

背景:最近的报告显示,早期精神病患者在症状改善一段时间后症状加重,即所谓的复发,可能会导致脑部变化和不良的疾病预后。我们推测,早期精神病复发患者的神经影像学可能存在实质性改变:我们研究了首次精神病事件后两年内的精神病患者和健康对照组。我们将患者分为两组,即在发病和磁共振成像(MRI)扫描之间没有复发的患者(未复发组)和在这两个时间点之间复发的患者(复发组)。通过调整人口统计学和临床混杂因素,我们分析了从静息态功能磁共振成像数据中得出的 78 个感兴趣区(ROI)之间的 3003 个功能连接估计值:我们对 85 名患者进行了研究,其中包括 54 名复发组患者和 31 名未复发组患者,以及 94 名健康对照组患者。经过多重比较校正后,我们观察到复发组和对照组之间的 47 个功能连接估计值存在明显差异,而未复发组和对照组之间则未发现差异。这些病理特征大多(64%)涉及丘脑。Jonckheere-Terpstra检验表明,从对照组到未复发组患者,再到复发组患者,所有47种功能连接变化都有显著的跨组进展:局限性:需要进行纵向研究,以进一步验证丘脑在复发中的参与程度和病理重要性:我们观察到了与早期精神病复发相关的神经元连接的病理差异,这种差异与丘脑的关系更为特殊。我们的研究表明,在精神病的发展轨迹中考虑与复发相关的神经生物学机制非常重要。
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Neuroimaging alterations and relapse in early-stage psychosis.

Background: Recent reports have indicated that symptom exacerbation after a period of improvement, referred to as relapse, in early-stage psychosis could result in brain changes and poor disease outcomes. We hypothesized that substantial neuroimaging alterations may exist among patients who experience relapse in early-stage psychosis.

Methods: We studied patients with psychosis within 2 years after the first psychotic event and healthy controls. We divided patients into 2 groups, namely those who did not experience relapse between disease onset and the magnetic resonance imaging (MRI) scan (no-relapse group) and those who did experience relapse between these 2 timings (relapse group). We analyzed 3003 functional connectivity estimates between 78 regions of interest (ROIs) derived from resting-state functional MRI data by adjusting for demographic and clinical confounding factors.

Results: We studied 85 patients, incuding 54 in the relapse group and 31 in the no-relapse group, along with 94 healthy controls. We observed significant differences in 47 functional connectivity estimates between the relapse and control groups after multiple comparison corrections, whereas no differences were found between the no-relapse and control groups. Most of these pathological signatures (64%) involved the thalamus. The Jonckheere-Terpstra test indicated that all 47 functional connectivity changes had a significant cross-group progression from controls to patients in the no-relapse group to patients in the relapse group.

Limitations: Longitudinal studies are needed to further validate the involvement and pathological importance of the thalamus in relapse.

Conclusion: We observed pathological differences in neuronal connectivity associated with relapse in early-stage psychosis, which are more specifically associated with the thalamus. Our study implies the importance of considering neurobiological mechanisms associated with relapse in the trajectory of psychotic disorders.

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来源期刊
CiteScore
6.80
自引率
2.30%
发文量
51
审稿时长
2 months
期刊介绍: The Journal of Psychiatry & Neuroscience publishes papers at the intersection of psychiatry and neuroscience that advance our understanding of the neural mechanisms involved in the etiology and treatment of psychiatric disorders. This includes studies on patients with psychiatric disorders, healthy humans, and experimental animals as well as studies in vitro. Original research articles, including clinical trials with a mechanistic component, and review papers will be considered.
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