Laboratory of NeuroGenetics (Romer, Elliott, Knodt, Sison, Hariri), Department of Psychology and Neuroscience (Romer, Knodt, Houts, Moffitt, Caspi, Hariri), Department of Psychiatry and Behavioral Sciences (Moffitt, Caspi), and Center for Genomic and Computational Biology (Moffitt, Caspi), Duke University, Durham, N.C.; Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand (Ireland, Ramrakha, Poulton); Christchurch Radiology Group, Christchurch, New Zealand (Keenan); Department of Medicine, University of Otago, Christchurch (Melzer); New Zealand Brain Research Institute, Christchurch (Melzer); Social, Genetic, and Developmental Psychiatry Research Center, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Moffitt, Caspi); and McLean Hospital/Harvard Medical School, Belmont, Mass. (Romer).
Am J Psychiatry. 2021 Feb 1;178(2):174-182. doi: 10.1176/appi.ajp.2020.19090934. Epub 2020 Jun 30.
Neuroimaging research has revealed that structural brain alterations are common across broad diagnostic families of disorders rather than specific to a single psychiatric disorder. Such overlap in the structural brain correlates of mental disorders mirrors already well-documented phenotypic comorbidity of psychiatric symptoms and diagnoses, which can be indexed by a general psychopathology or factor. The authors hypothesized that if general psychopathology drives the convergence of structural alterations common across disorders, then 1) there should be few associations unique to any one diagnostic family of disorders, and 2) associations with the factor should overlap with those for the broader diagnostic families.
Analyses were conducted on structural MRI and psychopathology data collected from 861 members of the population-representative Dunedin Multidisciplinary Health and Development Study at age 45.
Study members with high scores across three broad diagnostic families of disorders (externalizing, internalizing, thought disorder) exhibited highly overlapping patterns of reduced global and widely distributed parcel-wise neocortical thickness. Study members with high factor scores exhibited patterns of reduced global and parcel-wise neocortical thickness nearly identical to those associated with the three broad diagnostic families.
A pattern of pervasively reduced neocortical thickness appears to be common across all forms of mental disorders and may represent a transdiagnostic feature of general psychopathology. As has been documented with regard to symptoms and diagnoses, the underlying brain structural correlates of mental disorders may not exhibit specificity, and the continued pursuit of such specific correlates may limit progress toward more effective strategies for etiological understanding, prevention, and intervention.
神经影像学研究表明,结构性脑改变在广泛的障碍诊断家族中很常见,而不是特定于单一的精神障碍。精神障碍的结构性脑相关性的这种重叠反映了精神症状和诊断的已经充分记录的表型共病,这可以通过一般精神病理学或因素来索引。作者假设,如果一般精神病理学驱动常见于障碍的结构性改变的收敛,那么 1)应该很少有与任何一个特定的障碍诊断家族相关的关联,2)与因素的关联应该与更广泛的诊断家族的关联重叠。
对来自人口代表性的达尼丁多学科健康和发展研究的 861 名成员的结构 MRI 和精神病理学数据进行了分析,这些成员在 45 岁时接受了测量。
在三个广泛的障碍诊断家族(外化、内化、思维障碍)中得分较高的研究成员表现出高度重叠的减少全局和广泛分布的包裹式新皮质厚度的模式。在因素得分较高的研究成员中,发现了与三个广泛的障碍诊断家族相关的相似的减少全局和包裹式新皮质厚度的模式。
普遍减少的新皮质厚度模式似乎在所有形式的精神障碍中都很常见,可能代表一般精神病理学的跨诊断特征。正如已经记录的关于症状和诊断的那样,精神障碍的潜在脑结构相关性可能没有特异性,而继续追求这种特异性相关性可能会限制在病因理解、预防和干预方面取得更有效的策略的进展。