Fusar-Poli P, Smieskova R, Serafini G, Politi P, Borgwardt S
Department of Psychosis Studies, Institute of Psychiatry, King's College London , London , UK.
World J Biol Psychiatry. 2014 Apr;15(3):219-28. doi: 10.3109/15622975.2011.630408. Epub 2012 Jan 27.
To address at a meta-analytical level the neuroanatomical markers of genetic liability to psychosis and a of first episode of psychosis.
Fifteen voxel-based morphometry (VBM) studies of antipsychotic-naive subjects at genetic high-risk (HR) for psychosis or with a first-episode psychosis (FEP) were included in a Signed Differential Mapping (SDM) meta-analysis. Publication bias was assessed with funnel plots and Egger's intercept. Heterogeneity was assessed with Q statistics and I (2) index.
The database comprised 458 HR and 206 antipsychotic-naïve FEP subjects, matched with controls. Gray matter (GM) reductions as compared to controls, were observed in the left parahippocampal gyrus and in the bilateral anterior cingulate gyrus in the HR group, and in the right superior temporal gyrus, in the left insula and in the left cerebellum in the FEP group. Further GM decreases were observed in the FEP group as compared to the HR group in the left anterior cingulate, in the right precuneus, in the left cerebellum and in the right superior temporal gyrus. Limitations. The cross-sectional nature of the included studies prevented the comparison of high risk subjects who later did or did not develop a psychotic episode. Other caveats are based on the methodological heterogeneity across individual imaging studies.
GM reductions in the anterior cingulate are markers of genetic liability to psychosis while reductions in the superior temporal gyrus and cerebellum can be interpreted as markers of a first onset of the illness.
在荟萃分析层面探讨精神病遗传易感性及首次精神病发作的神经解剖学标志物。
对15项基于体素的形态学测量（VBM）研究进行了符号差异映射（SDM）荟萃分析，这些研究对象为精神病遗传高危（HR）或首次发作精神病（FEP）且未服用过抗精神病药物的受试者。采用漏斗图和Egger截距评估发表偏倚。用Q统计量和I²指数评估异质性。
数据库包括458名HR受试者和206名未服用过抗精神病药物的FEP受试者，并与对照组进行了匹配。与对照组相比，HR组左侧海马旁回和双侧前扣带回灰质减少，FEP组右侧颞上回、左侧岛叶和左侧小脑灰质减少。与HR组相比，FEP组左侧前扣带回、右侧楔前叶、左侧小脑和右侧颞上回灰质进一步减少。局限性。纳入研究的横断面性质妨碍了对后来出现或未出现精神病发作的高危受试者进行比较。其他注意事项基于个体影像学研究的方法学异质性。
前扣带回灰质减少是精神病遗传易感性的标志物，而颞上回和小脑灰质减少可解释为疾病首次发作的标志物。
