Mental Health Institute of The Second Xiangya Hospital, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, Hunan, China.
Department of Psychiatry, The University of Hong Kong, Hong Kong; Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong.
Psychiatry Res. 2015 Jul 30;233(1):57-63. doi: 10.1016/j.pscychresns.2015.04.011. Epub 2015 May 12.
Delusions of reference (DOR) are theoretically linked with aberrant salience and associative learning. Previous studies have shown that the caudate nucleus plays a critical role in the cognitive circuits of coding prediction errors and associative learning. The current study aimed at testing the hypothesis that abnormalities in the caudate nucleus may be involved in the neuroanatomical substrate of DOR. Structural magnetic resonance imaging of the brain was performed in 44 first-episode psychosis patients (with diagnoses of schizophrenia or schizophreniform disorder) and 25 healthy controls. Patients were divided into three groups according to symptoms: patients with DOR as prominent positive symptom; patients with prominent positive symptoms other than DOR; and patients with minimal positive symptoms. All groups were age-, gender-, and education-matched, and patient groups were matched for diagnosis, duration of illness, and antipsychotic treatment. Voxel-based morphometric analysis was performed to identify group differences in grey matter density. Relationships were explored between grey matter density and DOR. Patients with DOR were found to have reduced grey matter density in the caudate compared with patients without DOR and healthy controls. Grey matter density values of the left and right caudate head were negatively correlated with DOR severity. Decreased grey matter density in the caudate nucleus may underlie DOR in early psychosis.
关系妄想（DOR）与异常突显和联想学习理论上相关。先前的研究表明，尾状核在编码预测误差和联想学习的认知回路中起着关键作用。本研究旨在检验假设，即尾状核的异常可能与 DOR 的神经解剖学基础有关。对 44 名首发精神病患者（诊断为精神分裂症或精神分裂样障碍）和 25 名健康对照者进行了大脑结构磁共振成像。根据症状将患者分为三组：以 DOR 为突出阳性症状的患者；以 DOR 以外的突出阳性症状为特征的患者；以及阳性症状轻微的患者。所有组均按年龄、性别和教育程度匹配，患者组按诊断、病程和抗精神病药物治疗进行匹配。进行基于体素的形态计量学分析，以确定灰质密度的组间差异。探讨了灰质密度与 DOR 之间的关系。与无 DOR 患者和健康对照组相比，DOR 患者的尾状核灰质密度降低。左、右尾状核头部的灰质密度值与 DOR 严重程度呈负相关。尾状核灰质密度降低可能是早期精神病 DOR 的基础。
