首发精神病治疗反应的连接组学关联

Connectomic correlates of response to treatment in first-episode psychosis.

作者信息

Crossley Nicolas A, Marques Tiago Reis, Taylor Heather, Chaddock Chris, Dell'Acqua Flavio, Reinders Antje A T S, Mondelli Valeria, DiForti Marta, Simmons Andrew, David Anthony S, Kapur Shitij, Pariante Carmine M, Murray Robin M, Dazzan Paola

机构信息

Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK

Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago 8330077, Chile.

出版信息

Brain. 2017 Feb;140(2):487-496. doi: 10.1093/brain/aww297. Epub 2016 Dec 21.

Abstract

Connectomic approaches using diffusion tensor imaging have contributed to our understanding of brain changes in psychosis, and could provide further insights into the neural mechanisms underlying response to antipsychotic treatment. We here studied the brain network organization in patients at their first episode of psychosis, evaluating whether connectome-based descriptions of brain networks predict response to treatment, and whether they change after treatment. Seventy-six patients with a first episode of psychosis and 74 healthy controls were included. Thirty-three patients were classified as responders after 12 weeks of antipsychotic treatment. Baseline brain structural networks were built using whole-brain diffusion tensor imaging tractography, and analysed using graph analysis and network-based statistics to explore baseline characteristics of patients who subsequently responded to treatment. A subgroup of 43 patients was rescanned at the 12-week follow-up, to study connectomic changes over time in relation to treatment response. At baseline, those subjects who subsequently responded to treatment, compared to those that did not, showed higher global efficiency in their structural connectomes, a network configuration that theoretically facilitates the flow of information. We did not find specific connectomic changes related to treatment response after 12 weeks of treatment. Our data suggest that patients who have an efficiently-wired connectome at first onset of psychosis show a better subsequent response to antipsychotics. However, response is not accompanied by specific structural changes over time detectable with this method.

摘要

使用扩散张量成像的连接组学方法有助于我们理解精神病患者的大脑变化,并可能为抗精神病药物治疗反应的神经机制提供进一步的见解。我们在此研究了首次发作精神病患者的脑网络组织,评估基于连接组的脑网络描述是否能预测治疗反应,以及治疗后它们是否会发生变化。研究纳入了76例首次发作精神病的患者和74名健康对照。33例患者在接受12周抗精神病药物治疗后被归类为治疗反应者。使用全脑扩散张量成像纤维束成像构建基线脑结构网络,并使用图分析和基于网络的统计方法进行分析,以探索随后对治疗有反应的患者的基线特征。在12周随访时对43例患者的亚组进行了重新扫描,以研究与治疗反应相关的连接组随时间的变化。在基线时,与未对治疗产生反应的患者相比,那些随后对治疗有反应的患者在其结构连接组中表现出更高的全局效率,这种网络配置理论上有助于信息流动。在治疗12周后,我们未发现与治疗反应相关的特定连接组变化。我们的数据表明,在精神病首次发作时具有高效连接组的患者对抗精神病药物随后表现出更好的反应。然而,用这种方法无法检测到反应随时间伴随的特定结构变化。

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