van Haren Neeltje E M, Setiaman Nikita, Koevoets Martijn G J C, Baalbergen Heleen, Kahn Rene S, Hillegers Manon H J
Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, The Netherlands.
Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands.
Eur Psychiatry. 2020 Jan 31;63(1):e5. doi: 10.1192/j.eurpsy.2019.19.
Studying offspring of schizophrenia (SZo) and bipolar disorder patients (BDo) provides important information on the putative neurodevelopmental trajectories underlying development toward severe mental illnesses. We compared intracranial volume (ICV), as a marker for neurodevelopment, and global and local brain measures between SZo or BDo and control offspring (Co) in relation to IQ and psychopathology.
T1-weighted magnetic resonance imaging (MRI) brain scans were obtained from 146 participants (8-19 years; 40 SZo, 66 BDo, 40 Co). Linear mixed models were applied to compare ICV, global, and local brain measures between groups. To investigate the effect of ICV, IQ (four subtests Wechsler Intelligence Scale for Children/Wechsler Adult Intelligence Scale-III) or presence of psychopathology these variables were each added to the model.
SZo and BDo had significantly lower IQ and more often met criteria for a lifetime psychiatric disorder than Co. ICV was significantly smaller in SZo than in BDo (d = -0.56) and Co (d = -0.59), which was largely independent of IQ (respectively, d = -0.54 and d = -0.35). After ICV correction, the cortex was significantly thinner in SZo than in BDo (d = -0.42) and Co (d = -0.75) and lateral ventricles were larger in BDo than in Co (d = 0.55). Correction for IQ or lifetime psychiatric diagnosis did not change these findings.
Despite sharing a lower IQ and a higher prevalence of psychiatric disorders, brain abnormalities in BDo appear less pronounced (but are not absent) than in SZo. Lower ICV in SZo implies that familial risk for schizophrenia has a stronger association with stunted early brain development than familial risk for bipolar disorder.
对精神分裂症患者后代（SZo）和双相情感障碍患者后代（BDo）的研究为严重精神疾病发展背后假定的神经发育轨迹提供了重要信息。我们比较了作为神经发育标志物的颅内体积（ICV），以及SZo或BDo与对照后代（Co）之间的全脑和局部脑测量指标，并将其与智商和精神病理学相关联。
对146名参与者（8 - 19岁；40名SZo、66名BDo、40名Co）进行了T1加权磁共振成像（MRI）脑部扫描。应用线性混合模型比较组间的ICV、全脑和局部脑测量指标。为了研究ICV、智商（韦氏儿童智力量表/韦氏成人智力量表第三版的四个子测验）或精神病理学存在的影响，将这些变量分别添加到模型中。
SZo和BDo的智商显著低于Co，且比Co更常符合终生精神障碍的标准。SZo的ICV显著小于BDo（d = -0.56）和Co（d = -0.59），这在很大程度上与智商无关（分别为d = -0.54和d = -0.35）。在对ICV进行校正后，SZo的皮质显著比BDo（d = -0.42）和Co（d = -0.75）更薄，BDo的侧脑室比Co更大（d = 0.55）。对智商或终生精神疾病诊断进行校正并没有改变这些结果。
尽管SZo和BDo都有较低的智商和较高的精神疾病患病率，但BDo的脑异常似乎比SZo不那么明显（但并非不存在）。SZo中较低的ICV意味着精神分裂症的家族风险与早期脑发育迟缓的关联比双相情感障碍的家族风险更强。
