Bourque Josiane, Spechler Philip A, Potvin Stéphane, Whelan Robert, Banaschewski Tobias, Bokde Arun L W, Bromberg Uli, Büchel Christian, Quinlan Erin Burke, Desrivières Sylvane, Flor Herta, Frouin Vincent, Gowland Penny, Heinz Andreas, Ittermann Bernd, Martinot Jean-Luc, Paillère-Martinot Marie-Laure, McEwen Sarah C, Nees Frauke, Orfanos Dimitri Papadopoulos, Paus Tomáš, Poustka Luise, Smolka Michael N, Vetter Nora C, Walter Henrik, Schumann Gunter, Garavan Hugh, Conrod Patricia J
From the Department of Psychiatry, Université de Montréal, CHU Ste.-Justine Hospital and IUSMM Research Center, Montreal; the Departments of Psychiatry and Psychology, University of Vermont, Burlington; the Department of Psychology, University College Dublin, Dublin; the Department of Child and Adolescent Psychiatry and Psychotherapy and the Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; the Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany; the Discipline of Psychiatry, School of Medicine and Trinity College Institute of Neuroscience, Trinity College Dublin; the University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; the Medical Research Council-Social, Genetic and Developmental Psychiatry Centre and the Department of Psychological Medicine and Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, U.K.; Neurospin, Commissariat à l'Energie Atomique, CEA-Saclay Center, Paris; the Sir Peter Mansfield Imaging Centre School of Physics and Astronomy, University of Nottingham, Nottingham, U.K.; the Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité-Universitätsmedizin Berlin, Berlin; the Physikalisch-Technische Bundesanstalt, Braunschweig and Berlin, Germany; the Institut National de la Santé et de la Recherche Médicale, INSERM Unit 1000 "Neuroimaging and Psychiatry," University Paris Sud, University Paris Descartes-Sorbonne Paris Cité, Paris; the Maison de Solenn, Paris; the Department of Adolescent Psychopathology and Medicine, Maison de Solenn, Cochin Hospital, Paris; the Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles; the Rotman Research Institute, Baycrest, and the Departments of Psychology and Psychiatry, University of Toronto, Toronto; the Department of Child and Adolescent Psychiatry and Psychotherapy, Medical University of Vienna, Vienna; the Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany.
Am J Psychiatry. 2017 Jun 1;174(6):566-575. doi: 10.1176/appi.ajp.2017.16080897. Epub 2017 Mar 21.
This study investigated the neural correlates of psychotic-like experiences in youths during tasks involving inhibitory control, reward anticipation, and emotion processing. A secondary aim was to test whether these neurofunctional correlates of risk were predictive of psychotic symptoms 2 years later.
Functional imaging responses to three paradigms-the stop-signal, monetary incentive delay, and faces tasks-were collected in youths at age 14, as part of the IMAGEN study. At baseline, youths from London and Dublin sites were assessed on psychotic-like experiences, and those reporting significant experiences were compared with matched control subjects. Significant brain activity differences between the groups were used to predict, with cross-validation, the presence of psychotic symptoms in the context of mood fluctuation at age 16, assessed in the full sample. These prediction analyses were conducted with the London-Dublin subsample (N=246) and the full sample (N=1,196).
Relative to control subjects, youths reporting psychotic-like experiences showed increased hippocampus/amygdala activity during processing of neutral faces and reduced dorsolateral prefrontal activity during failed inhibition. The most prominent regional difference for classifying 16-year-olds with mood fluctuation and psychotic symptoms relative to the control groups (those with mood fluctuations but no psychotic symptoms and those with no mood symptoms) was hyperactivation of the hippocampus/amygdala, when controlling for baseline psychotic-like experiences and cannabis use.
The results stress the importance of the limbic network's increased response to neutral facial stimuli as a marker of the extended psychosis phenotype. These findings might help to guide early intervention strategies for at-risk youths.
本研究调查了青少年在涉及抑制控制、奖励预期和情绪处理的任务中类精神病体验的神经关联。第二个目的是测试这些风险的神经功能关联是否能预测两年后的精神病症状。
作为IMAGEN研究的一部分，收集了14岁青少年对三种范式（停止信号、金钱激励延迟和面孔任务）的功能成像反应。在基线时，对来自伦敦和都柏林站点的青少年进行类精神病体验评估，并将报告有显著体验的青少年与匹配的对照组进行比较。两组之间显著的脑活动差异被用于通过交叉验证预测16岁时在情绪波动背景下精神病症状的存在，该评估针对整个样本进行。这些预测分析在伦敦 - 都柏林子样本（N = 246）和整个样本（N = 1,196）中进行。
相对于对照组，报告有类精神病体验的青少年在处理中性面孔时海马体/杏仁核活动增加，在抑制失败时背外侧前额叶活动减少。在控制基线类精神病体验和大麻使用的情况下，与对照组（有情绪波动但无精神病症状的人和无情绪症状的人）相比，用于对有情绪波动和精神病症状的16岁青少年进行分类的最显著区域差异是海马体/杏仁核的过度激活。
结果强调了边缘网络对中性面部刺激反应增加作为扩展精神病表型标志物的重要性。这些发现可能有助于指导针对高危青少年的早期干预策略。
