神经影像学预测精神病转化——系统评价和荟萃分析。
Neuroimaging predictors of transition to psychosis--a systematic review and meta-analysis.
机构信息
Psychiatric Outpatient Department, Psychiatric University Clinics, Basel, Switzerland.
出版信息
Neurosci Biobehav Rev. 2010 Jul;34(8):1207-22. doi: 10.1016/j.neubiorev.2010.01.016. Epub 2010 Feb 6.
OBJECTIVES
In early stage psychosis research the identification of neurobiological correlates of vulnerability to schizophrenia is an important hurdle.
METHODS
We systematically reviewed the neuroimaging publications on high-risk subjects with subsequent transition to psychosis (HR-T) and conducted a meta-analysis calculating the effect size Cohen's d.
RESULTS
Out of 30 identified studies 25 met the inclusion criteria. Structural (s)MRI studies showed small to medium effect sizes of decreased prefrontal, cingulate, insular and cerebellar gray matter volume in HR-T compared to high-risk subjects without transition (HR-NT). Meta-analysis revealed relatively larger whole brain volumes in HR-T compared to HR-NT subjects (mean Cohen's d 0.36, 95% CI 0.27-0. 46). Compared to HR-NT, HR-T subjects showed in functional imaging studies reduced brain activation in prefrontal cortex, reduced neuronal density, and increased membrane turnover in frontal and cingulate cortex with medium to large effect sizes.
CONCLUSIONS
Despite methodological differences between studies, structural and neurochemical abnormalities in prefrontal, anterior cingulate, medial temporal and cerebellar cortex might be predictive for development of psychosis within HR subjects.
目的
在早期精神病学研究中，确定精神分裂症易感性的神经生物学相关性是一个重要的难题。
方法
我们系统地回顾了高风险人群（HR）向精神病过渡（HR-T）的神经影像学研究，并进行了荟萃分析，计算了 Cohen's d 的效应大小。
结果
在 30 项确定的研究中，有 25 项符合纳入标准。结构磁共振成像（sMRI）研究显示，与无过渡的高风险人群（HR-NT）相比，HR-T 患者的前额叶、扣带回、岛叶和小脑灰质体积减少，具有小至中等的效应大小。荟萃分析显示，与 HR-NT 相比，HR-T 患者的全脑体积相对较大（平均 Cohen's d 为 0.36，95%置信区间为 0.27-0.46）。与 HR-NT 相比，HR-T 患者在功能成像研究中表现出前额叶皮层激活减少、神经元密度降低以及前额叶和扣带回皮层的细胞膜周转率增加，具有中到大的效应大小。
结论
尽管研究之间存在方法学差异，但前额叶、前扣带回、内侧颞叶和小脑皮质的结构和神经化学异常可能是 HR 人群精神病发展的预测因素。
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