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皮质纹状体回路的功能连接与一般人群中的精神病样体验。

Functional Connectivity of Corticostriatal Circuitry and Psychosis-like Experiences in the General Community.

机构信息

Brain and Mental Health Research Hub, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Victoria, Australia; School of Psychological Sciences, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Victoria, Australia.

Brain and Mental Health Research Hub, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Victoria, Australia; School of Psychological Sciences, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Victoria, Australia.

出版信息

Biol Psychiatry. 2019 Jul 1;86(1):16-24. doi: 10.1016/j.biopsych.2019.02.013. Epub 2019 Feb 21.

Abstract

BACKGROUND

Psychotic symptoms are proposed to lie on a continuum, ranging from isolated psychosis-like experiences (PLEs) in nonclinical populations to frank disorder. Here, we investigated the neurobiological correlates of this continuum by examining whether functional connectivity of dorsal corticostriatal circuitry, which is disrupted in psychosis patients and individuals at high risk for psychosis, is associated with the severity of subclinical PLEs.

METHODS

A community sample of 672 adults with no history of psychiatric or neurological illnesses completed a battery of seven questionnaires spanning various PLE domains. Principal component analysis of 12 subscales taken from seven questionnaires was used to estimate major dimensions of PLEs. Dimension scores from principal component analysis were then correlated with whole-brain voxelwise functional connectivity maps of the dorsal striatum in a subset of 353 participants who completed a resting-state neuroimaging protocol.

RESULTS

Principal component analysis identified two dimensions of PLEs that accounted for 62.57% of variance in the measures, corresponding to positive (i.e., subthreshold delusions and hallucinations) and negative (i.e., subthreshold social and physical anhedonia) symptom-like PLEs. Reduced functional connectivity between the dorsal striatum and prefrontal and motor cortices correlated with more severe positive PLEs. Increased functional connectivity between the dorsal striatum and motor cortex was associated with more severe negative PLEs.

CONCLUSIONS

Consistent with past findings in patients and individuals at high risk for psychosis, subthreshold positive symptomatology is associated with reduced functional connectivity of the dorsal circuit. This finding suggests that the connectivity of this circuit tracks the expression of psychotic phenomena across a broad spectrum of severity, extending from the subclinical domain to clinical diagnosis.

摘要

背景

精神病症状被认为存在于一个连续体上,范围从非临床人群中的孤立性精神病样体验(PLEs)到明显的障碍。在这里,我们通过检查背侧皮质纹状体回路的功能连接是否与亚临床 PLEs 的严重程度相关,来研究这个连续体的神经生物学相关性。该回路在精神病患者和高风险精神病个体中受到破坏。

方法

一个没有精神或神经病史的 672 名成年人的社区样本完成了一套涵盖各种 PLE 领域的七个问卷。来自七个问卷的 12 个分量表的主成分分析用于估计 PLEs 的主要维度。然后,在完成静息状态神经影像学方案的 353 名参与者的亚集中,将主成分分析的维度得分与背侧纹状体的全脑体素功能连接图进行相关分析。

结果

主成分分析确定了两个 PLE 维度,它们占测量的 62.57%,对应于阳性(即亚阈值妄想和幻觉)和阴性(即亚阈值社交和身体快感缺失)症状样 PLEs。背侧纹状体与前额叶和运动皮层之间的功能连接减少与更严重的阳性 PLEs 相关。背侧纹状体与运动皮层之间的功能连接增加与更严重的阴性 PLEs 相关。

结论

与过去在精神病患者和高风险精神病个体中的发现一致,亚阈值阳性症状与背侧回路的功能连接减少有关。这一发现表明,该回路的连接性在广泛的严重程度范围内追踪了精神病现象的表达,从亚临床领域延伸到临床诊断。

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