Liloia Donato, Brasso Claudio, Cauda Franco, Mancuso Lorenzo, Nani Andrea, Manuello Jordi, Costa Tommaso, Duca Sergio, Rocca Paola
GCS-fMRI, Koelliker Hospital and Department of Psychology, University of Turin, Turin, Italy; Functional Neuroimaging and Complex Neural Systems (FOCUS) Laboratory, Department of Psychology, University of Turin, Turin, Italy.
Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy.
Neurosci Biobehav Rev. 2021 Apr;123:83-103. doi: 10.1016/j.neubiorev.2021.01.010. Epub 2021 Jan 23.
Characterizing neuroanatomical markers of different stages of schizophrenia (SZ) to assess pathophysiological models of how the disorder develops is an important target for the clinical practice. We performed a meta-analysis of voxel-based morphometry studies of genetic and clinical high-risk subjects (g-/c-HR), recently diagnosed (RDSZ) and chronic SZ patients (ChSZ). We quantified gray matter (GM) changes associated with these four conditions and compared them with contrast and conjunctional data. We performed the behavioral analysis and networks decomposition of alterations to obtain their functional characterization. Results reveal a cortical-subcortical, left-to-right homotopic progression of GM loss. The right anterior cingulate is the only altered region found altered among c-HR, RDSZ and ChSZ. Contrast analyses show left-lateralized insular, amygdalar and parahippocampal GM reduction in RDSZ, which appears bilateral in ChSZ. Functional decomposition shows involvement of the salience network, with an enlargement of the sensorimotor network in RDSZ and the thalamus-basal nuclei network in ChSZ. These findings support the current neuroprogressive models of SZ and integrate this deterioration with the clinical evolution of the disease.
确定精神分裂症（SZ）不同阶段的神经解剖学标志物，以评估该疾病发展的病理生理模型，是临床实践的一个重要目标。我们对基于体素的形态学研究进行了荟萃分析，这些研究涉及遗传和临床高危受试者（g-/c-HR）、近期确诊的患者（RDSZ）和慢性SZ患者（ChSZ）。我们量化了与这四种情况相关的灰质（GM）变化，并将它们与对比数据和联合数据进行比较。我们对改变进行了行为分析和网络分解，以获得其功能特征。结果显示GM损失呈现皮质-皮质下、从左到右的同位进展。右前扣带回是在c-HR、RDSZ和ChSZ中唯一发现有改变的区域。对比分析显示，RDSZ患者左侧岛叶、杏仁核和海马旁回的GM减少，而在ChSZ患者中则呈现双侧减少。功能分解显示突显网络参与其中，RDSZ患者的感觉运动网络扩大，ChSZ患者的丘脑-基底核网络扩大。这些发现支持了当前SZ的神经进展模型，并将这种恶化与疾病的临床演变相结合。
