Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.
Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan.
Schizophr Bull. 2020 Jul 8;46(4):834-845. doi: 10.1093/schbul/sbaa011.
Previous structural magnetic resonance imaging studies of psychotic disorders have demonstrated volumetric alterations in subcortical (ie, the basal ganglia, thalamus) and temporolimbic structures, which are involved in high-order cognition and emotional regulation. However, it remains unclear whether individuals at high risk for psychotic disorders with minimal confounding effects of medication exhibit volumetric changes in these regions. This multicenter magnetic resonance imaging study assessed regional volumes of the thalamus, caudate, putamen, nucleus accumbens, globus pallidus, hippocampus, and amygdala, as well as lateral ventricular volume using FreeSurfer software in 107 individuals with an at-risk mental state (ARMS) (of whom 21 [19.6%] later developed psychosis during clinical follow-up [mean = 4.9 years, SD = 2.6 years]) and 104 age- and gender-matched healthy controls recruited at 4 different sites. ARMS individuals as a whole demonstrated significantly larger volumes for the left caudate and bilateral lateral ventricles as well as a smaller volume for the right accumbens compared with controls. In male subjects only, the left globus pallidus was significantly larger in ARMS individuals. The ARMS group was also characterized by left-greater-than-right asymmetries of the lateral ventricle and caudate nucleus. There was no significant difference in the regional volumes between ARMS groups with and without later psychosis onset. The present study suggested that significant volume expansion of the lateral ventricle, caudate, and globus pallidus, as well as volume reduction of the accumbens, in ARMS subjects, which could not be explained only by medication effects, might be related to general vulnerability to psychopathology.
先前针对精神障碍的结构磁共振成像研究表明，皮质下结构（即基底神经节、丘脑）和颞叶边缘结构的体积发生了变化，这些结构与高级认知和情绪调节有关。然而，目前尚不清楚是否存在处于精神病高危状态但药物干扰较小的个体，这些区域是否存在体积变化。本多中心磁共振成像研究使用 FreeSurfer 软件评估了 107 名处于高危精神状态（ARMS）个体（其中 21 名[19.6%]在临床随访期间发展为精神病[平均=4.9 年，标准差=2.6 年]）和 104 名年龄和性别匹配的健康对照者的丘脑、尾状核、壳核、伏隔核、苍白球、海马和杏仁核的区域体积以及侧脑室体积。与对照组相比，ARMS 个体的左侧尾状核和双侧侧脑室体积明显增大，右侧伏隔核体积明显减小。仅在男性中，左苍白球在 ARMS 个体中明显增大。ARMS 组还表现为侧脑室和尾状核的左侧大于右侧不对称。有和无后续精神病发病的 ARMS 组之间的区域体积没有显著差异。本研究表明，ARMS 受试者侧脑室、尾状核和苍白球的显著扩张，以及伏隔核的体积缩小，不能仅用药物作用来解释，可能与精神病的普遍易感性有关。
