Semel Institute for Neuroscience and Behavior, University of California, Los Angeles, CA, USA.
Curr Pharm Des. 2012;18(4):422-33. doi: 10.2174/138161212799316073.
Schizophrenia is a disorder with a pronounced developmental component. Accordingly, there is a growing interest in characterizing developmental changes in the period leading up to disease onset, in an effort to develop effective preventative interventions. One of the ongoing neurodevelopmental changes known to occur in the late adolescent period that often overlaps with the prodromal phase and time of onset is white matter development and myelination. In this critical review, a disruption in the normal trajectory of white matter development could potentially play an important role in the onset of psychosis. We seek to summarize the existing state of research on white matter development in prodromal subjects, with a particular focus on diffusion tensor imaging (DTI) measures. First, we describe the physiological basis of developmental white matter changes and myelination. Next, we characterize the pattern of white matter changes associated with typical development across adolescence as measured with DTI. Then, we discuss white matter changes observed in adult patients with schizophrenia and in individuals seen in genetic and clinical high risk states. Finally, we discuss the implications of these findings for future research directions and for potential therapeutic interventions.
精神分裂症是一种具有明显发育成分的疾病。因此，人们越来越有兴趣描述疾病发作前的发育变化，以努力开发有效的预防干预措施。在青少年晚期经常与前驱期和发病时间重叠的已知持续神经发育变化之一是白质发育和髓鞘形成。在这篇重要的综述中，白质发育的正常轨迹中断可能在精神病的发作中发挥重要作用。我们试图总结前驱期受试者中白质发育的现有研究状况，特别关注扩散张量成像（DTI）测量。首先，我们描述了发育性白质变化和髓鞘形成的生理基础。接下来，我们描述了用 DTI 测量的与整个青春期典型发育相关的白质变化模式。然后，我们讨论了在成年精神分裂症患者和遗传和临床高危状态中观察到的白质变化。最后，我们讨论了这些发现对未来研究方向和潜在治疗干预的意义。
