Haller Sven, Borgwardt Stefan J, Schindler Christian, Aston Jacqueline, Radue Ernst W, Riecher-Rössler Anita
Institute of Radiology, Department of Neuroradiology, University Hospital Basel, Petersgraben 4, CH-4031 Basel, Switzerland.
Radiology. 2009 Jan;250(1):212-21. doi: 10.1148/radiol.2501072153.
To investigate whether cortical thickness analysis in individuals with an at-risk mental state (ARMS) might contribute to early detection of psychosis.
Ethics committee approval and written informed consent were obtained. Cortical thickness was analyzed because early disease-related morphometric changes were expected to be most pronounced in the cerebral cortex. With the assumption of progressive change in cortical thickness from control subjects, to those with an ARMS, and then to those who have had a first episode (FE) of psychosis, the brain regions that substantially differ between those with FE psychosis and control subjects were identified. Whether these regions help discriminate between the ARMS group and control subjects was tested. Because normal interindividual variation of cortical thickness, even for control subjects, may exceed that expected with early disease-related changes, intraindividual cortical thickness asymmetry was analyzed. Twenty age- and sex-matched individuals for each group (ARMS group, FE group, and control subjects) were recruited within a prospective early-detection study. High-spatial-resolution magnetization-prepared rapid gradient-echo magnetic resonance (MR) brain images were acquired with a 1.5-T MR imager. Cortical thickness asymmetry was analyzed in 41 anatomic regions corresponding to the Talairach standard brain atlas.
Direct cortical thickness analysis did not help distinguish between groups. Cortical thickness asymmetry analysis helped distinguish between groups (P = .007); variability increased from control subjects, to the ARMS group, and then to the FE group in seven anatomic regions (P < .0001). Cortical thickness asymmetry in these regions helped distinguish the FE group from control subjects (P = .0006; sensitivity, 70.0%; specificity, 85.0%) and showed a trend toward helping to distinguish the ARMS group from control subjects (P = .06; sensitivity, 75.0%; specificity, 65.0%).
Cortical thickness asymmetry analysis is more accurate than direct cortical thickness measurement in distinguishing the control from the FE group and might contribute to early detection of an ARMS.
研究处于高危精神状态（ARMS）个体的皮质厚度分析是否有助于早期发现精神病。
获得伦理委员会批准及书面知情同意书。由于预期早期疾病相关的形态学变化在大脑皮质最为明显，因此对皮质厚度进行分析。假设从对照受试者到ARMS个体，再到首次发作（FE）精神病患者，皮质厚度会逐渐变化，确定FE精神病患者与对照受试者之间存在显著差异的脑区。测试这些区域是否有助于区分ARMS组与对照受试者。由于即使是对照受试者，皮质厚度的个体间正常变异也可能超过早期疾病相关变化预期的范围，因此分析了个体内皮质厚度不对称性。在一项前瞻性早期检测研究中，每组（ARMS组、FE组和对照受试者）招募了20名年龄和性别匹配的个体。使用1.5-T磁共振成像仪获取高空间分辨率的磁化准备快速梯度回波磁共振（MR）脑图像。在与Talairach标准脑图谱对应的41个解剖区域分析皮质厚度不对称性。
直接皮质厚度分析无助于区分各组。皮质厚度不对称性分析有助于区分各组（P = 0.007）；在7个解剖区域，变异性从对照受试者到ARMS组，再到FE组逐渐增加（P < 0.0001）。这些区域的皮质厚度不对称性有助于区分FE组与对照受试者（P = 0.0006；敏感性，70.0%；特异性，85.0%），并显示出有助于区分ARMS组与对照受试者的趋势（P = 0.06；敏感性，75.0%；特异性，65.0%）。
在区分对照与FE组方面，皮质厚度不对称性分析比直接皮质厚度测量更准确，可能有助于早期发现ARMS。
