Mental Health Centre Copenhagen, Copenhagen University Hospital, Hellerup, Denmark.
Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Centre Glostrup, Copenhagen University Hospital, Glostrup, Denmark.
Acta Psychiatr Scand. 2018 Jan;137(1):65-78. doi: 10.1111/acps.12835. Epub 2017 Nov 16.
The neurodevelopmental hypothesis of psychosis suggests that disrupted white matter (WM) maturation underlies disease onset. In this longitudinal study, we investigated WM connectivity and compared WM changes between individuals at ultra-high-risk for psychosis (UHR) and healthy controls (HCs).
Thirty UHR individuals and 23 HCs underwent MR diffusion tensor imaging before and after 12 months of non-manualized standard care. Positive and negative symptoms and level of functioning were assessed. Tract-based spatial statistics were employed.
During 12 months, none of the UHR individuals transitioned to psychosis. Both UHR individuals and HCs increased significantly in fractional anisotropy (FA). UHR individuals showed significant FA increases predominantly in the left superior longitudinal fasciculus (SLF) (P = 0.01), and HCs showed significant FA increases in the left uncinate fasciculus (P = 0.03). Within UHR individuals, a significant positive correlation between FA change and age was observed predominantly in the left SLF (P = 0.02). Within HCs, no significant correlation between FA change and age was observed. No significant correlations between baseline FA and clinical outcomes were observed; however, FA changes were significantly positively correlated to changes in negative symptoms (P = 0.04).
As normal brain maturation occurs in a posterior to frontal direction, our findings could suggest disturbed WM maturation in UHR individuals.
精神病的神经发育假说表明,疾病的发生是由于白质(WM)成熟过程的中断。在这项纵向研究中,我们研究了 WM 的连接性,并比较了精神病超高风险个体(UHR)和健康对照组(HC)之间的 WM 变化。
30 名 UHR 个体和 23 名 HC 在接受非标准化标准护理 12 个月前后接受了 MR 扩散张量成像。评估了阳性和阴性症状以及功能水平。采用基于束的空间统计学方法。
在 12 个月内,没有一名 UHR 个体发展为精神病。UHR 个体和 HC 组的各向异性分数(FA)均显著增加。UHR 个体主要在左侧上纵束(SLF)中显示出显著的 FA 增加(P = 0.01),而 HC 组在左侧钩束(uncinate fasciculus,UF)中显示出显著的 FA 增加(P = 0.03)。在 UHR 个体中,FA 变化与年龄之间存在显著的正相关,主要出现在左侧 SLF(P = 0.02)。在 HC 组中,FA 变化与年龄之间没有显著的相关性。基线 FA 与临床结局之间没有显著相关性;然而,FA 变化与阴性症状的变化呈显著正相关(P = 0.04)。
由于正常脑成熟是从前向后的,我们的发现可能表明 UHR 个体 WM 成熟过程受损。