Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, USA.
Psychiatry Clin Neurosci. 2020 Jan;74(1):1-11. doi: 10.1111/pcn.12927. Epub 2019 Oct 9.
An examination of electroencephalographic and magnetoencephalographic studies demonstrates how age-related changes in brain neural function temporally constrain their use as diagnostic markers. A first example shows that, given maturational changes in the resting-state peak alpha frequency in typically developing children but not in children who have autism spectrum disorder (ASD), group differences in alpha-band activity characterize only a subset of children who have ASD. A second example, auditory encoding processes in schizophrenia, shows that the complication of normal age-related brain changes on detecting and interpreting group differences in neural activity is not specific to children. MRI studies reporting group differences in the rate of brain maturation demonstrate that a group difference in brain maturation may be a concern for all diagnostic brain markers. Attention to brain maturation is needed whether one takes a DSM-5 or a Research Domain Criteria approach to research. For example, although there is interest in cross-diagnostic studies comparing brain measures in ASD and schizophrenia, such studies are difficult given that measures are obtained in one group well after and in the other much closer to the onset of symptoms. In addition, given differences in brain activity among infants, toddlers, children, adolescents, and younger and older adults, creating tasks and research designs that produce interpretable findings across the life span and yet allow for development is difficult at best. To conclude, brain imaging findings show an effect of brain maturation on diagnostic markers separate from (and potentially difficult to distinguish from) effects of disease processes. Available research with large samples already provides direction about the age range(s) when diagnostic markers are most robust and informative.
对脑电图和脑磁图研究的考察表明，大脑神经功能的年龄相关性变化如何在时间上限制了它们作为诊断标志物的应用。第一个例子表明，在典型发育儿童中，静息状态下的阿尔法波频率会随着年龄的增长而变化，但在自闭症谱系障碍（ASD）儿童中则不会，因此，只有一部分 ASD 儿童的阿尔法频带活动存在组间差异。第二个例子，即精神分裂症的听觉编码过程，表明正常的年龄相关性大脑变化对检测和解释神经活动的组间差异的影响并不仅限于儿童。报告大脑成熟率组间差异的 MRI 研究表明，大脑成熟率的组间差异可能是所有诊断性大脑标志物都需要关注的问题。无论采用 DSM-5 还是研究领域标准（Research Domain Criteria）方法进行研究，都需要注意大脑成熟度。例如，尽管人们对跨诊断研究比较 ASD 和精神分裂症的大脑测量值很感兴趣，但由于在一组中获得的测量值远远晚于另一组，而且更接近症状出现的时间，因此这些研究很难进行。此外，由于婴儿、学步儿童、儿童、青少年以及年轻和年长成年人之间的大脑活动存在差异，因此，创建可在整个生命周期内产生可解释结果且允许发育的任务和研究设计是非常困难的。总之，脑成像研究结果表明，大脑成熟度对诊断标志物的影响与疾病过程的影响是分开的（并且可能难以区分）。已有研究表明，在多大的年龄范围内，诊断标志物最具稳健性和信息量。
