Cognitive Neuropsychiatry Lab, Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Rudolf-Bultmann-Str. 8, 35039, Marburg, Germany.
Center for Mind, Brain and Behavior (CMBB), Hans-Meerwein-Str. 6, 35032, Marburg, Germany.
Eur Arch Psychiatry Clin Neurosci. 2021 Sep;271(6):1111-1122. doi: 10.1007/s00406-020-01229-5. Epub 2021 Feb 2.
In the general population, psychosis risk phenotypes occur independently of attenuated prodromal syndromes. Neurobiological correlates of vulnerability could help to understand their meaningfulness. Interactions between the occurrence of psychotic-like experiences (PLE) and other psychological factors e.g., distress related to PLE, may distinguish psychosis-prone individuals from those without risk of future psychotic disorder. We aimed to investigate whether (a) correlates of total PLE and distress, and (b) symptom dimension-specific moderation effects exist at the brain structural level in non-help-seeking adults reporting PLE below and above the screening criterion for clinical high-risk (CHR). We obtained T1-weighted whole-brain MRI scans from 104 healthy adults from the community without psychosis CHR states for voxel-based morphometry (VBM). Brain structural associations with PLE and PLE distress were analysed with multiple linear regression models. Moderation of PLE by distress severity of two types of positive symptoms from the Prodromal Questionnaire (PQ-16) screening inventory was explored in regions-of-interest after VBM. Total PQ-16 score was positively associated with grey matter volume (GMV) in prefrontal regions, occipital fusiform and lingual gyri (p < 0.05, FDR peak-level corrected). Overall distress severity and GMV were not associated. Examination of distress severity on the positive symptom dimensions as moderators showed reduced strength of the association between PLE and rSFG volume with increased distress severity for perceptual PLE. In this study, brain structural variation was related to PLE level, but not distress severity, suggesting specificity. In healthy individuals, positive relationships between PLE and prefrontal volumes may indicate protective features, which supports the insufficiency of PLE for the prediction of CHR. Additional indicators of vulnerability, such as distress associated with perceptual PLE, change the positive brain structure relationship. Brain structural findings may strengthen clinical objectives through disentanglement of innocuous and risk-related PLE.
在普通人群中,精神病风险表型独立于减弱的前驱综合征出现。易感性的神经生物学相关性有助于理解其意义。精神病样体验(PLE)的发生与其他心理因素(例如与 PLE 相关的痛苦)之间的相互作用可能将有精神病倾向的个体与没有未来精神病障碍风险的个体区分开来。我们旨在研究以下两个方面是否存在相关性:(a)PLE 和痛苦的总相关物,以及(b)在报告 PLE 低于和高于临床高风险(CHR)筛选标准的无求助的成年人群体的大脑结构水平上是否存在症状维度特异性的调节效应。我们从社区中没有精神病 CHR 状态的 104 名健康成年人中获得了 T1 加权全脑 MRI 扫描,用于基于体素的形态测量学(VBM)。使用多元线性回归模型分析了 PLE 和 PLE 痛苦与大脑结构的相关性。在 VBM 后,使用 Prodromal Questionnaire(PQ-16)筛查清单中的两种阳性症状的类型对 PLE 进行了基于区域的调节分析。总体 PQ-16 评分与前额叶区域、枕叶梭状回和舌回的灰质体积(GMV)呈正相关(p < 0.05,FDR 峰值水平校正)。整体痛苦严重程度与 GMV 无关。对作为调节因素的阳性症状维度上的痛苦严重程度进行检查显示,随着感知 PLE 的痛苦严重程度的增加,PLE 与 rSFG 体积之间的关联强度降低。在这项研究中,大脑结构的变化与 PLE 水平相关,而与痛苦严重程度无关,表明具有特异性。在健康个体中,PLE 与前额叶体积之间的正相关关系可能表明具有保护作用,这支持了 PLE 不足以预测 CHR。与感知 PLE 相关的痛苦等脆弱性的附加指标会改变大脑结构的阳性关系。大脑结构研究结果可以通过解开无害和相关的 PLE 来增强临床目标。