Borgwardt Stefan J, Riecher-Rössler Anita, Dazzan Paola, Chitnis Xavier, Aston Jacqueline, Drewe Margret, Gschwandtner Ute, Haller Sven, Pflüger Marlon, Rechsteiner Evelyne, D'Souza Marcus, Stieglitz Rolf-Dieter, Radü Ernst-Wilhelm, McGuire Philip K
Psychiatric Outpatient Department, University Hospital Basel, Switzerland.
Biol Psychiatry. 2007 May 15;61(10):1148-56. doi: 10.1016/j.biopsych.2006.08.009. Epub 2006 Nov 13.
Individuals with an At Risk Mental State (ARMS) have a very high risk of developing a psychotic disorder but the basis of this risk is unclear. We addressed this issue by studying gray matter volume in this group with magnetic resonance imaging (MRI).
Thirty-five individuals with an ARMS, 25 patients with first episode schizophrenia, and 22 healthy volunteers were studied using a 1.5T MRI scanner. Twelve (34%) of the ARMS group developed schizophrenia in the 2 years subsequent to scanning.
There were significant volumetric differences between the three groups in the left insula, superior temporal gyrus, cingulate gyrus and precuneus. In these regions, the volume in the ARMS group was smaller than in volunteers but not significantly different from that in the first episode (FE) group. Direct comparison of the ARMS and control groups revealed additional areas of reduced volume in the left medial temporal cortex. Within the ARMS group, those subjects who later developed psychosis had less gray matter than subjects who did not in the right insula, inferior frontal and superior temporal gyrus.
The ARMS was associated with reductions in gray matter volume in areas that are also reduced in schizophrenia, suggesting that these are a correlate of an increased vulnerability to psychosis. Volumetric differences within the ARMS group may be related to the subsequent onset of schizophrenia in a subset of those at high risk.
处于高危精神状态（ARMS）的个体患精神分裂症的风险非常高，但这种风险的基础尚不清楚。我们通过磁共振成像（MRI）研究该组的灰质体积来解决这个问题。
使用1.5T MRI扫描仪对35名处于ARMS状态的个体、25名首次发作的精神分裂症患者和22名健康志愿者进行研究。在扫描后的2年里，ARMS组中有12人（34%）患上了精神分裂症。
三组在左侧脑岛、颞上回、扣带回和楔前叶的体积存在显著差异。在这些区域，ARMS组的体积小于志愿者组，但与首次发作（FE）组无显著差异。ARMS组与对照组的直接比较显示，左侧颞叶内侧皮质还有其他体积减小的区域。在ARMS组中，那些后来发展为精神病的受试者在右侧脑岛、额下回和颞上回的灰质比未发展为精神病的受试者少。
ARMS与精神分裂症中也减少的区域的灰质体积减少有关，这表明这些是对精神病易感性增加的一个相关因素。ARMS组内的体积差异可能与一部分高危人群随后发生精神分裂症有关。
