Department of Psychiatry, University of Basel, c/o University Hospital Basel, Petersgraben 4, Basel 4031, Switzerland.
Hum Brain Mapp. 2012 Oct;33(10):2281-94. doi: 10.1002/hbm.21360. Epub 2011 Sep 16.
Neurofunctional alterations are correlates of vulnerability to psychosis, as well as of the disorder itself. How these abnormalities relate to different probabilities for later transition to psychosis is unclear. We investigated vulnerability- versus disease-related versus resilience biomarkers of psychosis during working memory (WM) processing in individuals with an at-risk mental state (ARMS).
Patients with "first-episode psychosis" (FEP, n = 21), short-term ARMS (ARMS-ST, n = 17), long-term ARMS (ARMS-LT, n = 16), and healthy controls (HC, n = 20) were investigated with an n-back WM task. We examined functional magnetic resonance imaging (fMRI) and structural magnetic resonance imaging (sMRI) data in conjunction using biological parametric mapping (BPM) toolbox.
There were no differences in accuracy, but the FEP and the ARMS-ST group had longer reaction times compared with the HC and the ARMS-LT group. With the 2-back > 0-back contrast, we found reduced functional activation in ARMS-ST and FEP compared with the HC group in parietal and middle frontal regions. Relative to ARMS-LT individuals, FEP patients showed decreased activation in the bilateral inferior frontal gyrus and insula, and in the left prefrontal cortex. Compared with the ARMS-LT, the ARMS-ST subjects showed reduced activation in the right inferior frontal gyrus and insula. Reduced insular and prefrontal activation was associated with gray matter volume reduction in the same area in the ARMS-LT group.
These findings suggest that vulnerability to psychosis was associated with neurofunctional alterations in fronto-temporo-parietal networks in a WM task. Neurofunctional differences within the ARMS were related to different duration of the prodromal state and resilience factors.
神经功能改变是易患精神病的相关因素，也是疾病本身的相关因素。这些异常与后来发展为精神病的不同可能性有何关系尚不清楚。我们研究了处于高危精神状态（ARMS）的个体在工作记忆（WM）处理过程中，精神病的易感性相关、疾病相关和恢复力相关生物标志物。
我们对 21 名“首发精神病”（FEP）患者、17 名短期 ARMS（ARMS-ST）患者、16 名长期 ARMS（ARMS-LT）患者和 20 名健康对照（HC）进行了 n-back WM 任务的研究。我们结合使用生物参数映射（BPM）工具箱，对功能磁共振成像（fMRI）和结构磁共振成像（sMRI）数据进行了研究。
在准确性方面没有差异，但 FEP 和 ARMS-ST 组的反应时间长于 HC 和 ARMS-LT 组。与 2-back > 0-back 对比，我们发现与 HC 组相比，ARMS-ST 和 FEP 组在顶叶和中额叶区域的功能激活减少。与 ARMS-LT 个体相比，FEP 患者双侧额下回和岛叶以及左前额皮质的激活减少。与 ARMS-LT 相比，ARMS-ST 患者右侧额下回和岛叶的激活减少。岛叶和前额叶的激活减少与 ARMS-LT 组相同区域的灰质体积减少有关。
这些发现表明，易患精神病与 WM 任务中额颞顶叶网络的神经功能改变有关。ARMS 内的神经功能差异与前驱期的不同持续时间和恢复力因素有关。
