Hanlon Faith M, Dodd Andrew B, Ling Josef M, Shaff Nicholas A, Stephenson David D, Bustillo Juan R, Stromberg Shannon F, Lin Denise S, Ryman Sephira G, Mayer Andrew R
The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM 87106, USA.
Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque, NM 87131, USA.
Schizophr Res. 2021 Mar;229:12-21. doi: 10.1016/j.schres.2021.01.016. Epub 2021 Feb 17.
Patients with psychotic spectrum disorders (PSD) exhibit similar patterns of atrophy and microstructural changes that may be associated with common symptomatology (e.g., symptom burden and/or cognitive impairment). Gray matter concentration values (proxy for atrophy), fractional anisotropy (FA), mean diffusivity (MD), intracellular neurite density (V) and isotropic diffusion volume (V) measures were therefore compared in 150 PSD (schizophrenia, schizoaffective disorder, and bipolar disorder Type I) and 63 healthy controls (HC). Additional analyses evaluated whether regions showing atrophy and/or microstructure abnormalities were better explained by DSM diagnoses, symptom burden or cognitive dysfunction. PSD exhibited increased atrophy within bilateral medial temporal lobes and subcortical structures. Gray matter along the left lateral sulcus showed evidence of increased atrophy and MD. Increased MD was also observed in homotopic fronto-temporal regions, suggesting it may serve as a precursor to atrophic changes. Global cognitive dysfunction, rather than DSM diagnoses or psychotic symptom burden, was the best predictor of increased gray matter MD. Regions of decreased FA (i.e., left frontal gray and white matter) and V (i.e., frontal and temporal regions and along central sulcus) were also observed for PSD, but were neither spatially concurrent with atrophic regions nor associated with clinical symptoms. Evidence of expanding microstructural spaces in gray matter demonstrated the greatest spatial overlap with current and potentially future regions of atrophy, and was associated with cognitive deficits. These results suggest that this particular structural abnormality could potentially underlie global cognitive impairment that spans traditional diagnostic categories.
患有精神分裂症谱系障碍（PSD）的患者表现出类似的萎缩和微观结构变化模式，这些变化可能与常见症状（如症状负担和/或认知障碍）相关。因此，对150名PSD患者（精神分裂症、分裂情感性障碍和I型双相情感障碍）和63名健康对照者（HC）的灰质浓度值（萎缩的替代指标）、分数各向异性（FA）、平均扩散率（MD）、细胞内神经突密度（V）和各向同性扩散体积（V）测量值进行了比较。额外的分析评估了显示萎缩和/或微观结构异常的区域是否能更好地由DSM诊断、症状负担或认知功能障碍来解释。PSD患者双侧内侧颞叶和皮质下结构内的萎缩增加。左侧外侧沟沿线的灰质显示出萎缩和MD增加的迹象。在同位的额颞区域也观察到MD增加，这表明它可能是萎缩变化的前兆。整体认知功能障碍，而非DSM诊断或精神病性症状负担，是灰质MD增加的最佳预测指标。PSD患者还观察到FA降低的区域（即左侧额叶灰质和白质）和V降低的区域（即额叶和颞叶区域以及中央沟沿线），但这些区域在空间上既不与萎缩区域同时出现，也与临床症状无关。灰质中微观结构空间扩大的证据表明，其与当前及潜在的未来萎缩区域有最大的空间重叠，并且与认知缺陷相关。这些结果表明，这种特定的结构异常可能是跨越传统诊断类别的整体认知障碍的潜在基础。
