Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, School of Medicine, National University of Ireland Galway, H91TK33 Galway, Ireland.
Faculty of Health & Social Science, Institute of Medical Imaging & Visualisation, Bournemouth University, Bournemouth, United Kingdom.
Psychiatry Res Neuroimaging. 2020 Aug 30;302:111100. doi: 10.1016/j.pscychresns.2020.111100. Epub 2020 May 15.
The association of neuroanatomical progression with cognitive and clinical deterioration after first-episode of psychosis remains uncertain. This longitudinal study aims to assess whether i)impaired executive functioning and emotional intelligence at first presentation are associated with progressive prefrontal and orbitofrontal cortical thinning ii)negative symptom severity is linked to progressive prefrontal cortical thinning. 1.5T MRI images were acquired at baseline and after 3.5 years for 20 individuals with first-episode psychosis and 18 controls. The longitudinal pipeline of Freesurfer was employed to parcellate prefrontal cortex at two time points. Baseline cognitive performance was compared between diagnostic groups using MANCOVA. Partial correlations investigated relationships between cognition and negative symptoms at baseline and cortical thickness change over time. Patients displayed poorer performance than controls at baseline in working memory, reasoning/problem solving and emotional intelligence. In patients, loss of prefrontal and orbitofrontal thickness over time was predicted by impaired working memory and emotional intelligence respectively at baseline. Moreover, exploratory analyses revealed that the worsening of negative symptoms over time was significantly related to prefrontal cortical thinning. Results indicate that specific cognitive deficits at the onset of psychotic illness are markers of progressive neuroanatomical deficits and that worsening of negative symptoms occurs with prefrontal thickness reduction as the illness progresses.
首发精神病后神经解剖进展与认知和临床恶化的相关性仍不确定。本纵向研究旨在评估：i）首发时执行功能和情绪智力受损是否与前额叶和眶额皮质变薄的进展有关；ii）阴性症状严重程度是否与前额叶皮质变薄的进展有关。对 20 名首发精神病患者和 18 名对照者在基线和 3.5 年后分别进行了 1.5T MRI 成像。采用 Freesurfer 的纵向管道在两个时间点对前额叶皮质进行分割。使用 MANCOVA 比较诊断组之间的基线认知表现。在基线和随时间的皮质厚度变化之间进行了部分相关性研究，以评估认知与阴性症状之间的关系。与对照组相比，患者在基线时的工作记忆、推理/解决问题和情绪智力方面表现较差。在患者中，工作记忆和情绪智力受损分别预测了前额叶和眶额皮质随时间的变薄。此外，探索性分析表明，随时间推移阴性症状的恶化与前额叶皮质变薄显著相关。结果表明，精神病发病时的特定认知缺陷是神经解剖学进展的标志物，随着疾病的进展，阴性症状的恶化与前额叶厚度的减少有关。
