Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
Department of Psychology, Harvard University, Cambridge, MA, USA.
Psychol Med. 2020 Jan;50(2):273-283. doi: 10.1017/S0033291718004221. Epub 2019 Feb 12.
Subclinical delusional ideas, including persecutory beliefs, in otherwise healthy individuals are heritable symptoms associated with increased risk for psychotic illness, possibly representing an expression of one end of a continuum of psychosis severity. The identification of variation in brain function associated with these symptoms may provide insights about the neurobiology of delusions in clinical psychosis.
A resting-state functional magnetic resonance imaging scan was collected from 131 young adults with a wide range of severity of subclinical delusional beliefs, including persecutory ideas. Because of evidence for a key role of the amygdala in fear and paranoia, resting-state functional connectivity of the amygdala was measured.
Connectivity between the amygdala and early visual cortical areas, including striate cortex (V1), was found to be significantly greater in participants with high (n = 43) v. low (n = 44) numbers of delusional beliefs, particularly in those who showed persistence of those beliefs. Similarly, across the full sample, the number of and distress associated with delusional beliefs were positively correlated with the strength of amygdala-visual cortex connectivity. Moreover, further analyses revealed that these effects were driven by those who endorsed persecutory beliefs.
These findings are consistent with the hypothesis that aberrant assignments of threat to sensory stimuli may lead to the downstream development of delusional ideas. Taken together with prior findings of disrupted sensory-limbic coupling in psychosis, these results suggest that altered amygdala-visual cortex connectivity could represent a marker of psychosis-related pathophysiology across a continuum of symptom severity.
亚临床妄想观念,包括被害妄想,在其他健康个体中是可遗传的症状,与精神病风险增加相关,可能代表精神病严重程度连续体的一端的表现。与这些症状相关的大脑功能变化的识别可能为精神病性妄想的神经生物学提供一些见解。
对 131 名具有广泛亚临床妄想信念严重程度的年轻成年人(包括被害观念)进行了静息态功能磁共振成像扫描。由于杏仁核在恐惧和偏执狂中的关键作用的证据,测量了杏仁核的静息态功能连接。
与杏仁核和早期视觉皮层区域(包括纹状皮层(V1))的连接在具有高(n=43)和低(n=44)数量的妄想信念的参与者中显着更高,特别是在那些信念持续存在的参与者中。同样,在整个样本中,妄想信念的数量和与之相关的痛苦与杏仁核-视觉皮层连接的强度呈正相关。此外,进一步的分析表明,这些效应是由那些支持被害妄想的人驱动的。
这些发现与假设一致,即对感觉刺激的威胁的异常分配可能导致妄想观念的下游发展。与精神病中感觉-边缘连接中断的先前发现相结合,这些结果表明,杏仁核-视觉皮层连接的改变可能代表整个症状严重程度连续体中与精神病相关的病理生理学的标志物。