Zhou Yan-Fang, Huang Jun-Chao, Zhang Ping, Fan Feng-Mei, Chen Song, Fan Hong-Zhen, Cui Yi-Min, Luo Xing-Guang, Tan Shu-Ping, Wang Zhi-Ren, Feng Wei, Yuan Ying, Yang Fu-De, Savransky Anya, Ryan Meghann, Goldwaser Eric, Chiappelli Joshua, Rowland Laura M, Kochunov Peter, Tan Yun-Long, Hong L Elliot
Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, P. R. China.
Department of Pharmacy, Peking University First Hospital, Beijing, P. R. China.
Schizophr Bull. 2020 Apr 10;46(3):722-731. doi: 10.1093/schbul/sbz100.
Although schizophrenia is a brain disorder, increasing evidence suggests that there may be body-wide involvement in this illness. However, direct evidence of brain structures involved in the presumed peripheral-central interaction in schizophrenia is still unclear. Seventy-nine previously treatment-naïve first-episode schizophrenia patients who were within 2-week antipsychotics initial stabilization, and 41 age- and sex-matched healthy controls were enrolled in the study. Group differences in subcortical brain regional structures measured by MRI and the subclinical cardiovascular, metabolic, immune, and neuroendocrine biomarkers as indexed by allostatic load, and their associations were explored. Compared with controls, patients with schizophrenia had significantly higher allostatic load (P = .001). Lateral ventricle (P < .001), choroid plexus (P < .001), and thalamus volumes (P < .001) were significantly larger, whereas amygdala volume (P = .001) was significantly smaller in patients. The choroid plexus alone was significantly correlated with higher allostatic load after age, sex, education level, and the total intracranial volume were taken into account (t = 3.60, P < .001). Allostatic load was also significantly correlated with PANSS positive (r = 0.28, P = .016) and negative (r = -0.31, P = .008) symptoms, but in opposite directions. The peripheral multisystemic and central nervous system abnormalities in schizophrenia may interact through the choroid plexus during the early stage of the illness. The choroid plexus might provide a sensitive structural biomarker to study the treatment and prevention of brain-periphery interaction abnormalities in schizophrenia.
尽管精神分裂症是一种脑部疾病，但越来越多的证据表明，这种疾病可能涉及全身。然而，精神分裂症中假定的外周 - 中枢相互作用所涉及的脑结构的直接证据仍不清楚。本研究纳入了79例之前未接受过治疗的首发精神分裂症患者，这些患者处于抗精神病药物初始稳定治疗的2周内，以及41例年龄和性别匹配的健康对照者。通过MRI测量的皮质下脑区结构的组间差异，以及由应激负荷指数化的亚临床心血管、代谢、免疫和神经内分泌生物标志物，并探讨它们之间的关联。与对照组相比，精神分裂症患者的应激负荷显著更高（P = 0.001）。患者的侧脑室（P < 0.001）、脉络丛（P < 0.001）和丘脑体积（P < 0.001）显著更大，而杏仁核体积（P = 0.001）显著更小。在考虑年龄、性别、教育水平和总颅内体积后，仅脉络丛与更高的应激负荷显著相关（t = 3.60，P < 0.001）。应激负荷也与PANSS阳性（r = 0.28，P = 0.016）和阴性（r = -0.31，P = 0.008）症状显著相关，但方向相反。精神分裂症患者外周多系统和中枢神经系统异常可能在疾病早期通过脉络丛相互作用。脉络丛可能为研究精神分裂症脑 - 外周相互作用异常的治疗和预防提供一个敏感的结构生物标志物。
