Jason Smucny, Tyler A Lesh, Marina D Albuquerque, Joshua P Rhilinger, Cameron S Carter
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引用次数: 0
摘要
背景和假设:确定能预测早期精神病(EP)治疗反应的生物标志物是精神病学研究的当务之急。之前的研究表明,静息态连接生物标志物可能具有预测作用,尽管之前的研究结果在方向和幅度上存在很大差异。在此,我们评估了注意力、默认模式和显著性静息态网络的内在功能连通性与 EP 12 个月临床改善之间的关系:研究设计:58 名 EP 患者(发病不足 2 年,35 名男性,平均年龄 20 岁)拥有基线和随访临床数据,并被纳入最终样本。其中,30 名 EP 患者的简明精神病评定量表(BPRS)总分在随访时改善了 20% 以上,被归类为 "改善者":预测 "改善者 "状态的总体逻辑回归结果是显著的(χ2 = 23.66,Nagelkerke's R2 = 0.45,P 结论:这些结果表明,静息疗法对 "改善者 "状态的预测是显著的:总之,这些结果表明,静息态功能磁共振成像连通性可作为新近发病的精神病患者临床预后的有用生物标志物。
Predicting Clinical Improvement in Early Psychosis Using Circuit-Based Resting-State Functional Magnetic Resonance Imaging.
Background and hypothesis: Identifying biomarkers that predict treatment response in early psychosis (EP) is a priority for psychiatry research. Previous work suggests that resting-state connectivity biomarkers may have promise as predictive measures, although prior results vary considerably in direction and magnitude. Here, we evaluated the relationship between intrinsic functional connectivity of the attention, default mode, and salience resting-state networks and 12-month clinical improvement in EP.
Study design: Fifty-eight individuals with EP (less than 2 years from illness onset, 35 males, average age 20 years) had baseline and follow-up clinical data and were included in the final sample. Of these, 30 EPs showed greater than 20% improvement in Brief Psychiatric Rating Scale (BPRS) total score at follow-up and were classified as "Improvers."
Study results: The overall logistic regression predicting Improver status was significant (χ2 = 23.66, Nagelkerke's R2 = 0.45, P < .001, with 85% concordance). Significant individual predictors of Improver status included higher default mode within-network connectivity, higher attention-default mode between-network connectivity, and higher attention-salience between-network connectivity. Including baseline BPRS as a predictor increased model significance and concordance to 92%, and the model was not significantly influenced by the dose of antipsychotic medication (chlorpromazine equivalents). Linear regression models predicting percent change in BPRS were also significant.
Conclusions: Overall, these results suggest that resting-state functional magnetic resonance imaging connectivity may serve as a useful biomarker of clinical outcomes in recent-onset psychosis.
期刊介绍:
Schizophrenia Bulletin seeks to review recent developments and empirically based hypotheses regarding the etiology and treatment of schizophrenia. We view the field as broad and deep, and will publish new knowledge ranging from the molecular basis to social and cultural factors. We will give new emphasis to translational reports which simultaneously highlight basic neurobiological mechanisms and clinical manifestations. Some of the Bulletin content is invited as special features or manuscripts organized as a theme by special guest editors. Most pages of the Bulletin are devoted to unsolicited manuscripts of high quality that report original data or where we can provide a special venue for a major study or workshop report. Supplement issues are sometimes provided for manuscripts reporting from a recent conference.