Child and Adolescent Psychiatry Department,Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense,IiSGM, CIBERSAM. Ibiza 43,28009 Madrid,Spain.
Department of Experimental Medicine,Hospital General Universitario Gregorio Marañón,IiSGM, CIBERSAM,Ibiza 43, 28009 Madrid,Spain.
Psychol Med. 2017 Oct;47(14):2472-2482. doi: 10.1017/S0033291717000988. Epub 2017 Apr 24.
Autism Spectrum Disorders (ASD) and psychosis share deficits in social cognition. The insular region has been associated with awareness of self and reality, which may be basic for proper social interactions.
Total and regional insular volume and thickness measurements were obtained from a sample of 30 children and adolescents with ASD, 29 with early onset first-episode psychosis (FEP), and 26 healthy controls (HC). Total, regional, and voxel-level volume and thickness measurements were compared between groups (with correction for multiple comparisons), and the relationship between these measurements and symptom severity was explored.
Compared with HC, a shared volume deficit was observed for the right (but not the left) anterior insula (ASD: p = 0.007, FEP: p = 0.032), and for the bilateral posterior insula: (left, ASD: p = 0.011, FEP: p = 0.033; right, ASD: p = 0.004, FEP: p = 0.028). A voxel-based morphometry (VBM) conjunction analysis showed that ASD and FEP patients shared a gray matter volume and thickness deficit in the left posterior insula. Within patients, right anterior (r = -0.28, p = 0.041) and left posterior (r = -0.29, p = 0.030) insular volumes negatively correlated with the severity of insight deficits, and left posterior insular volume negatively correlated with the severity of 'autistic-like' symptoms (r = -0.30, p = 0.028).
The shared reduced volume and thickness in the anterior and posterior regions of the insula in ASD and FEP provides the first tentative evidence that these conditions share structural pathology that may be linked to shared symptomatology.
自闭症谱系障碍（ASD）和精神病共享社会认知缺陷。脑岛区域与自我和现实意识有关，这可能是适当社交互动的基础。
从 30 名 ASD 儿童和青少年、29 名首发精神病（FEP）和 26 名健康对照组中获得总脑岛和局部脑岛的体积和厚度测量值。在组间进行了总脑岛、局部脑岛和体素水平的体积和厚度测量值比较（进行了多次比较的校正），并探讨了这些测量值与症状严重程度之间的关系。
与健康对照组相比，右侧（而非左侧）前脑岛（ASD：p = 0.007，FEP：p = 0.032）和双侧后脑岛（左侧，ASD：p = 0.011，FEP：p = 0.033；右侧，ASD：p = 0.004，FEP：p = 0.028）存在共享的体积缺陷。基于体素形态计量学（VBM）联合分析显示，ASD 和 FEP 患者的左后脑岛存在灰质体积和厚度缺陷。在患者中，右侧前脑岛（r = -0.28，p = 0.041）和左侧后脑岛（r = -0.29，p = 0.030）的体积与洞察力缺陷的严重程度呈负相关，左侧后脑岛体积与“自闭症样”症状的严重程度呈负相关（r = -0.30，p = 0.028）。
ASD 和 FEP 患者前脑岛和后脑岛区域的体积和厚度的共享减少提供了第一个初步证据，表明这些疾病具有共享的结构病理学，可能与共享的症状学有关。
