精神分裂症影像学遗传易感性:患者非精神病亲属的 fMRI 研究的系统评价。

Imaging genetic liability to schizophrenia: systematic review of FMRI studies of patients' nonpsychotic relatives.

机构信息

Department of Psychology, University of Minnesota, N218 Elliott Hall, 75 East River Road, Minneapolis, MN 55455, USA.

出版信息

Schizophr Bull. 2009 Nov;35(6):1142-62. doi: 10.1093/schbul/sbn053. Epub 2008 Jun 12.

Abstract

There is a growing literature on brain activity in the nonpsychotic first-degree relatives of patients with schizophrenia as measured using functional imaging. This systematic review examined 20 studies in 4 domains of cognition, including cognitive control (7 samples), working memory (5 samples), long-term memory (4 samples), and language (4 samples). While the literature was widely divergent, these studies did consistently find activation differences between patients' relatives and controls. The most consistent increases in activation within hemisphere were found in right ventral prefrontal cortex (PFC) and right parietal cortex. Abnormal activity, defined as significant increases or decreases in activation relative to controls irrespective of hemisphere, was found in about two-thirds of contrasts in the cerebellum, dorsal prefrontal, lateral temporal, and parietal cortices, and thalamus, with basal ganglia and ventral PFC showing abnormalities in approximately half of those contrasts. Anterior cingulate was generally spared in patients' relatives. The diversity of findings in studies of patients' relatives may derive from differences between the cognitive demands across studies. We identify avenues for building a more accurate and cumulative literature, including symmetrical inclusion criteria for relatives and controls, recording in-scanner responses, using both a priori and whole-brain tests, explicitly reporting threshold values, reporting main effects of task, reporting effect sizes, and quantifying the risk of false negatives. While functional imaging in the relatives of schizophrenia patients remains a promising methodology for understanding the impact of the unexpressed genetic liability to schizophrenia, no single region or mechanism of abnormalities has yet emerged.

摘要

越来越多的文献研究了精神分裂症患者非精神病一级亲属的大脑活动,这些研究使用功能成像技术进行测量。本系统综述检查了认知的 4 个领域的 20 项研究,包括认知控制(7 个样本)、工作记忆(5 个样本)、长时记忆(4 个样本)和语言(4 个样本)。尽管文献广泛存在差异,但这些研究确实一致发现患者亲属和对照组之间存在激活差异。在半球内发现的最一致的激活增加是在右腹侧前额叶皮层(PFC)和右顶叶皮层。异常活动,定义为相对于对照组的激活显著增加或减少,与小脑、背侧前额叶、外侧颞叶和顶叶皮层以及丘脑的约三分之二的对比有关,基底神经节和腹侧 PFC 在这些对比的大约一半中表现出异常。前扣带回在患者亲属中一般未受影响。患者亲属研究中的发现多样性可能源于研究之间认知需求的差异。我们确定了建立更准确和累积文献的途径,包括对亲属和对照组采用对称的纳入标准、记录扫描中的反应、使用先验和全脑测试、明确报告阈值、报告任务的主要效应、报告效应大小以及量化假阴性的风险。虽然精神分裂症患者亲属的功能成像仍然是理解未表达的精神分裂症遗传易感性的影响的有前途的方法,但尚未出现单一的异常区域或机制。

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