Department of Psychosis Studies, Section of Early Psychosis, Institute of Psychiatry, King's College London, De Crespigny Park, London, UK.
Schizophr Bull. 2012 Sep;38(5):1083-91. doi: 10.1093/schbul/sbr035. Epub 2011 Apr 25.
It remains unclear whether brain structural abnormalities observed before the onset of psychosis are specific to schizophrenia or are common to all psychotic disorders. This study aimed to measure regional gray matter volume prior to the onset of schizophreniform and of affective psychoses. We investigated 102 subjects at ultrahigh risk (UHR) of developing psychosis recruited from the Personal Assessment and Crisis Evaluation Clinic in Melbourne, Australia. Twenty-eight of these subjects developed psychosis subsequent to scanning: 19 schizophrenia, 7 affective psychoses, and 2 other psychoses. We examined regional gray matter volume using 1.5 mm thick, coronal, 1.5 Tesla magnetic resonance imaging and voxel-based morphometry methods of image analysis. Subjects were scanned at presentation and were followed up clinically for a minimum of 12 months, to detect later transition to psychosis. We found that both groups of subjects who subsequently developed psychosis (schizophrenia and affective psychosis) showed reductions in the frontal cortex relative to UHR subjects who did not develop psychosis. The subgroup that subsequently developed schizophrenia also showed smaller volumes in the parietal cortex and, at trend level, in the temporal cortex, whereas those who developed an affective psychosis had significantly smaller subgenual cingulate volumes. These preliminary findings suggest that volumetric abnormalities in UHR individuals developing schizophrenia vs affective psychoses comprise a combination of features that predate both disorders and others that may be specific to the nature of the subsequent disorder.
精神分裂症发病前观察到的脑结构异常是否特异性地存在于精神分裂症，还是普遍存在于所有精神病性障碍中，目前尚不清楚。本研究旨在测量精神分裂样和情感性精神病发病前的区域性灰质体积。我们从澳大利亚墨尔本个人评估和危机评估诊所招募了 102 名超高风险（UHR）发生精神病的受试者，对他们进行了研究。这些受试者中有 28 人在扫描后出现了精神病：19 人患有精神分裂症，7 人患有情感性精神病，2 人患有其他精神病。我们使用 1.5 毫米厚的冠状 1.5 特斯拉磁共振成像和基于体素的形态计量学图像分析方法检查了区域性灰质体积。受试者在就诊时进行扫描，并进行了至少 12 个月的临床随访，以检测以后是否发生精神病。我们发现，随后发生精神病（精神分裂症和情感性精神病）的两组受试者与未发生精神病的 UHR 受试者相比，额叶皮层的灰质体积减少。随后发展为精神分裂症的亚组还显示顶叶皮层和颞叶皮层的体积较小，而发展为情感性精神病的亚组则显示出明显较小的扣带回下区体积。这些初步发现表明，在 UHR 个体中，发展为精神分裂症与情感性精神病的个体的体积异常包括两种特征：一种是两种疾病之前就存在的特征，另一种是可能与随后发生的疾病性质有关的特征。
