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[首发精神病的脑成像]

[Brain imaging of first-episode psychosis].

作者信息

Jardri R

机构信息

Pôle de psychiatrie et laboratoire de neurosciences fonctionnelles, Université Lille Nord de France, CURE, Centre universitaire de recherche et d'explorations, Hôpital Fontan, rue André-Verhaeghe, CHRU de Lille, F-59037 Lille cedex, France; Pathologies, Université droit et santé Lille (UDSL) INSERM U-960, Group for Neural Theory, DEC, École normale supérieure, Paris, France.

出版信息

Encephale. 2013 Sep;39 Suppl 2:S93-8. doi: 10.1016/S0013-7006(13)70102-7.

Abstract

In the last decades, schizophrenia has intensively been studied using various brain imaging techniques. However, several potential confounding factors limited their interpretation power (e.g. chronicity, the impact of antipsychotic medication). By considering psychosis as a continuum of changes starting from mild cognitive impairments to serious psychotic symptoms, it became possible to provide deeper insight in the neurobiological mechanisms underlying the onset of psychosis by focusing on at-risk individuals and first-episodes. Recent brain imaging meta-analyses of the first episode psychosis (FEP), noteworthy reported conjoint bilateral structural and functional differences at the level of the insula, the superior temporal gyrus and the medial frontal gyrus, encompassing the anterior cingulate cortex. In the present review, we thus provide an update of brain imaging studies of FEP with a particular emphasis on more recent anatomical, functional and molecular explorations. Specifically, we provide 1) a review of the common features observed in individuals with high risk for psychosis and changes characterizing the transition to psychosis, 2) a description of the environmental and drug factors influencing these abnormalities, 3) how these findings in FEP may differ from those observed in chronic individuals with schizophrenia, and 4) a short overview of new classification algorithms able to use MRI findings as valuable biomarkers to guide early detection in the prodromal phase of psychosis.

摘要

在过去几十年中,人们使用各种脑成像技术对精神分裂症进行了深入研究。然而,一些潜在的混杂因素限制了这些技术的解释力(例如病程、抗精神病药物的影响)。通过将精神病视为一个从轻度认知障碍到严重精神病症状的连续变化过程,有可能通过关注高危个体和首发患者来更深入地了解精神病发作背后的神经生物学机制。最近对首发精神病(FEP)的脑成像荟萃分析值得注意地报告了在脑岛、颞上回和内侧额回(包括前扣带回皮质)水平上联合的双侧结构和功能差异。在本综述中,我们因此提供了FEP脑成像研究的最新进展,特别强调了最近的解剖学、功能和分子探索。具体而言,我们提供:1)对精神病高危个体中观察到的共同特征以及向精神病转变所具有的特征性变化的综述;2)对影响这些异常的环境和药物因素的描述;3)FEP中的这些发现如何可能与慢性精神分裂症患者中观察到的发现不同;4)对能够将MRI结果用作有价值的生物标志物以指导精神病前驱期早期检测的新分类算法的简要概述。

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