处于精神病超高风险个体的小脑网络:对姿势摇摆和症状严重程度的影响。
Cerebellar networks in individuals at ultra high-risk of psychosis: impact on postural sway and symptom severity.
作者信息
Bernard Jessica A, Dean Derek J, Kent Jerillyn S, Orr Joseph M, Pelletier-Baldelli Andrea, Lunsford-Avery Jessica R, Gupta Tina, Mittal Vijay A
机构信息
Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado.
出版信息
Hum Brain Mapp. 2014 Aug;35(8):4064-78. doi: 10.1002/hbm.22458. Epub 2014 Jan 24.
Despite known deficits in postural control in patients with schizophrenia, this domain has not been investigated in youth at ultra high-risk (UHR) for psychosis. This is particularly relevant as postural control implicates dysfunction in the cerebellum-a region implicated in cognitive dysmetria conceptions of schizophrenia but poorly understood in the prodrome. Here, we extended our understanding of movement abnormalities in UHR individuals to include postural control, and have linked these deficits to both symptom severity and cerebello-cortical network connectivity. UHR and healthy control participants completed an instrumentally based balance task to quantify postural control along with a resting state brain imaging scan to investigate cerebellar networks. We also quantified positive and negative symptom severity with structured clinical interviews. The UHR group showed overall increased postural sway and decreased cerebello-cortical resting state connectivity, relative to controls. The decreased cerebello-cortical connectivity was seen across multiple networks. Postural sway was also correlated with cerebellar connectivity in this population and uniquely positively correlated with the severity of negative symptoms. Finally, symptom severity was also associated with cerebellar connectivity. Together, our results point to a potential deficit in sensory integration as an underlying contributor to the increased postural sway, and provide evidence of cerebellar abnormalities in UHR individuals. These results extend our understanding of the motor abnormalities of UHR individuals beyond striatum-based dyskinesias to include postural control and sensory integration deficits, and implicate the cerebellum as a distinct neural substrate preceding the onset of psychosis. Taken together, our results extend the cognitive dysmetria framework to UHR populations.
尽管已知精神分裂症患者存在姿势控制缺陷,但这一领域尚未在超高危(UHR)精神病青年中进行研究。这一点尤为重要,因为姿势控制涉及小脑功能障碍——小脑是一个与精神分裂症的认知失调概念相关但在前驱期了解甚少的区域。在这里,我们扩展了对UHR个体运动异常的理解,将姿势控制纳入其中,并将这些缺陷与症状严重程度和小脑-皮质网络连通性联系起来。UHR组和健康对照组参与者完成了一项基于仪器的平衡任务,以量化姿势控制,并进行了静息态脑成像扫描,以研究小脑网络。我们还通过结构化临床访谈对阳性和阴性症状的严重程度进行了量化。与对照组相比,UHR组总体上姿势摆动增加,小脑-皮质静息态连通性降低。多个网络均出现小脑-皮质连通性降低。在这一人群中,姿势摆动也与小脑连通性相关,且与阴性症状的严重程度呈独特的正相关。最后,症状严重程度也与小脑连通性相关。总之,我们的结果表明,感觉整合方面可能存在缺陷是姿势摆动增加的潜在原因,并为UHR个体的小脑异常提供了证据。这些结果将我们对UHR个体运动异常的理解从基于纹状体的运动障碍扩展到包括姿势控制和感觉整合缺陷,并表明小脑是精神病发作前一个独特的神经基质。综上所述,我们的结果将认知失调框架扩展到了UHR人群。