University of California, Los Angeles, Department of Psychology, Los Angeles, CA 90095–1563, USA.
Schizophr Res. 2012 Jan;134(1):1-9. doi: 10.1016/j.schres.2011.10.005. Epub 2011 Nov 6.
Emotion processing deficits are prominent in schizophrenia and exist prior to the onset of overt psychosis. However, developmental trajectories of neural circuitry subserving emotion regulation and the role that they may play in illness onset have not yet been examined in patients at risk for psychosis. The present study employed a cross-sectional analysis to examine age-related functional activation in amygdala and prefrontal cortex, as well as functional connectivity between these regions, in adolescents at clinical high risk (CHR) for psychosis relative to typically developing adolescents. Participants (n=34) performed an emotion processing fMRI task, including emotion labeling, emotion matching, and non-emotional control conditions. Regression analyses were used to predict activation in the amygdala and ventrolateral prefrontal cortex (vlPFC) based on age, group, sex, and the interaction of age by group. CHR adolescents exhibited altered age-related variation in amygdala and vlPFC activation, relative to controls. Controls displayed decreased amygdala and increased vlPFC activation with age, while patients exhibited the opposite pattern (increased amygdala and decreased vlPFC activation), suggesting a failure of prefrontal cortex to regulate amygdala reactivity. Moreover, a psychophysiological interaction analysis revealed decreased amygdala-prefrontal functional connectivity among CHR adolescents, consistent with disrupted brain connectivity as a vulnerability factor in schizophrenia. These results suggest that the at-risk syndrome is marked by abnormal development and functional connectivity of neural systems subserving emotion regulation. Longitudinal data are needed to confirm aberrant developmental trajectories intra-individually and to examine whether these abnormalities are predictive of conversion to psychosis, and of later deficits in socioemotional functioning.
情绪处理缺陷在精神分裂症中很明显，并且存在于明显精神病发作之前。然而，情绪调节神经回路的发育轨迹以及它们在精神病发病中的作用尚未在精神病高危患者中进行研究。本研究采用横断面分析，检查了精神病高危青少年（CHR）相对于正常发育青少年的杏仁核和前额叶皮层的年龄相关功能激活，以及这些区域之间的功能连接。参与者（n=34）执行了情绪处理 fMRI 任务，包括情绪标记、情绪匹配和非情绪控制条件。回归分析用于根据年龄、组、性别以及年龄与组的交互作用来预测杏仁核和腹外侧前额叶皮层（vlPFC）的激活。与对照组相比，CHR 青少年的杏仁核和 vlPFC 激活的年龄相关变化发生改变。对照组随年龄增加而表现出杏仁核减少和 vlPFC 激活增加，而患者则表现出相反的模式（杏仁核增加和 vlPFC 激活减少），表明前额叶皮层无法调节杏仁核反应。此外，心理生理相互作用分析显示 CHR 青少年的杏仁核-前额叶功能连接减少，这与精神分裂症中大脑连接作为易感性因素的破坏一致。这些结果表明，高危综合征的特征是情绪调节神经系统的异常发育和功能连接。需要纵向数据来确认个体内部的异常发育轨迹，并检查这些异常是否可预测向精神病的转变，以及后来的社会情感功能缺陷。
