Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany.
Department of Psychiatry (UPK), University of Basel, Basel, Switzerland.
Mol Psychiatry. 2020 Nov;25(11):2773-2785. doi: 10.1038/s41380-020-0679-7. Epub 2020 Feb 17.
The introduction of clinical criteria for the operationalization of psychosis high risk provided a basis for early detection and treatment of vulnerable individuals. However, about two-thirds of people meeting clinical high-risk (CHR) criteria will never develop a psychotic disorder. In the effort to increase prognostic precision, structural and functional neuroimaging have received growing attention as a potentially useful resource in the prediction of psychotic transition in CHR patients. The present review summarizes current research on neuroimaging biomarkers in the CHR state, with a particular focus on their prognostic utility and limitations. Large, multimodal/multicenter studies are warranted to address issues important for clinical applicability such as generalizability and replicability, standardization of clinical definitions and neuroimaging methods, and consideration of contextual factors (e.g., age, comorbidity).
临床标准的引入为精神分裂症高危人群的操作化提供了基础，以便早期发现和治疗易患个体。然而，大约三分之二符合临床高风险（CHR）标准的人永远不会发展出精神病障碍。为了提高预后的准确性，结构和功能神经影像学作为 CHR 患者发生精神病转变的预测的一种潜在有用资源，越来越受到关注。本综述总结了 CHR 状态下神经影像学生物标志物的当前研究，特别关注其预后效用和局限性。需要进行大型的、多模态/多中心研究，以解决与临床应用相关的重要问题，例如可推广性和可重复性、临床定义和神经影像学方法的标准化，以及考虑背景因素（例如，年龄、合并症）。
