University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
Support Center for Advanced Neuroimaging (SCAN), Institute for Diagnostic and Interventional Neuroradiology, University of Bern, Bern, Switzerland.
Schizophr Bull. 2018 Jan 13;44(1):182-192. doi: 10.1093/schbul/sbx070.
Increased striatal dopaminergic activity and decreased prefrontal functioning have been reported in individuals at clinical high risk (CHR) for psychosis. Abnormal metabolic rate might affect resting-state cerebral blood flow (rCBF) in the respective regions. Here, we examined if striatal and prefrontal rCBF differ between patients with CHR, first-episode psychosis (FEP), chronic schizophrenia-spectrum disorder (SZ) and controls. Two cohorts with a total of 122 participants were included and analyzed separately: 32 patients with SZ and 31 healthy controls (HC) from the University Hospital of Psychiatry, and 59 patients from the Bern Early Recognition and Intervention Center (29 with CHR, 12 with FEP, and 18 clinical controls [CC]). Ultra-high risk criteria were assessed with the Structured Interview for Psychosis-Risk Syndromes, basic symptom criteria with the Schizophrenia Proneness Instrument. rCBF was measured with pseudo-continuous arterial spin labeling 3T-Magnetic Resonance Imaging. Striatal rCBF was significantly increased and prefrontal rCBF significantly decreased in the SZ group compared to HC group and in the CHR and FEP groups compared to CC group. Striatal rCBF correlated significantly with positive symptom scores in SZ and CHR. An inverse correlation between striatal and frontal rCBF was found in controls (HC, CC), but not in patient groups (SZ, FEP, CHR). This is the first study to demonstrate increased neuronal activity within the striatum, but reduced prefrontal activity in patients with CHR, FEP, and SZ compared to the respective controls. Our results indicate that alterations in striatal and prefrontal rCBF are reflecting metabolic abnormalities preceding the onset of frank psychosis.
纹状体多巴胺能活性增加和前额叶功能降低已在精神病临床高风险（CHR）个体中报道。异常代谢率可能会影响相应区域的静息状态脑血流（rCBF）。在这里，我们研究了 CHR、首发精神病（FEP）、慢性精神分裂症谱系障碍（SZ）患者与对照组之间纹状体和前额叶 rCBF 是否存在差异。共有 122 名参与者被纳入并分别进行分析：来自大学医院精神病学的 32 名 SZ 患者和 31 名健康对照者（HC），以及来自伯尔尼早期识别和干预中心的 59 名患者（29 名 CHR、12 名 FEP 和 18 名临床对照者[CC]）。使用精神病风险综合征结构化访谈评估超高风险标准，使用精神分裂症倾向量表评估基本症状标准。使用伪连续动脉自旋标记 3T-MRI 测量 rCBF。与 HC 组和 CHR 和 FEP 组与 CC 组相比，SZ 组纹状体 rCBF 显著增加，前额叶 rCBF 显著降低。SZ 和 CHR 中，纹状体 rCBF 与阳性症状评分显著相关。在对照组（HC、CC）中发现纹状体和额叶 rCBF 之间呈负相关，但在患者组（SZ、FEP、CHR）中未发现这种相关性。这是第一项表明 CHR、FEP 和 SZ 患者的纹状体神经元活动增加，但前额叶活动减少，与各自对照组相比的研究。我们的研究结果表明，纹状体和前额叶 rCBF 的改变反映了在明显精神病发作之前的代谢异常。
