Department of Psychiatry, University of Basel, Switzerland.
Psychol Med. 2012 Aug;42(8):1613-25. doi: 10.1017/S0033291711002716. Epub 2011 Nov 30.
Although individuals vulnerable to psychosis show brain volumetric abnormalities, structural alterations underlying different probabilities for later transition are unknown. The present study addresses this issue by means of voxel-based morphometry (VBM).
We investigated grey matter volume (GMV) abnormalities by comparing four neuroleptic-free groups: individuals with first episode of psychosis (FEP) and with at-risk mental state (ARMS), with either long-term (ARMS-LT) or short-term ARMS (ARMS-ST), compared to the healthy control (HC) group. Using three-dimensional (3D) magnetic resonance imaging (MRI), we examined 16 FEP, 31 ARMS, clinically followed up for on average 3 months (ARMS-ST, n=18) and 4.5 years (ARMS-LT, n=13), and 19 HC.
The ARMS-ST group showed less GMV in the right and left insula compared to the ARMS-LT (Cohen's d 1.67) and FEP groups (Cohen's d 1.81) respectively. These GMV differences were correlated positively with global functioning in the whole ARMS group. Insular alterations were associated with negative symptomatology in the whole ARMS group, and also with hallucinations in the ARMS-ST and ARMS-LT subgroups. We found a significant effect of previous antipsychotic medication use on GMV abnormalities in the FEP group.
GMV abnormalities in subjects at high clinical risk for psychosis are associated with negative and positive psychotic symptoms, and global functioning. Alterations in the right insula are associated with a higher risk for transition to psychosis, and thus may be related to different transition probabilities.
尽管易患精神病的个体表现出脑容量异常，但导致后续不同转变概率的结构改变尚不清楚。本研究通过基于体素的形态测量学（VBM）来解决这个问题。
我们通过比较四个未经神经安定剂治疗的组来研究灰质体积（GMV）异常：首发精神病（FEP）和有风险的精神状态（ARMS）个体，以及长期（ARMS-LT）或短期 ARMS（ARMS-ST），与健康对照组（HC）进行比较。使用三维（3D）磁共振成像（MRI），我们检查了 16 名 FEP、31 名 ARMS，平均随访 3 个月（ARMS-ST，n=18）和 4.5 年（ARMS-LT，n=13）以及 19 名 HC。
ARMS-ST 组与 ARMS-LT（Cohen's d 1.67）和 FEP 组相比，右侧和左侧岛叶的 GMV 较少（Cohen's d 1.81）。这些 GMV 差异与整个 ARMS 组的整体功能呈正相关。整个 ARMS 组的岛叶改变与阴性症状相关，与 ARMS-ST 和 ARMS-LT 亚组的幻觉也相关。我们发现，在 FEP 组中，先前使用抗精神病药物与 GMV 异常之间存在显著关联。
处于精神病高临床风险的个体的 GMV 异常与阳性和阴性精神病症状以及整体功能有关。右侧岛叶的改变与向精神病转变的风险较高相关，因此可能与不同的转变概率有关。
