Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany.
Center for Mind Brain and Behavior, University of Marburg, Marburg, Germany.
Schizophr Bull. 2021 Oct 21;47(6):1740-1750. doi: 10.1093/schbul/sbab037.
More than a century of research on the neurobiological underpinnings of major psychiatric disorders (major depressive disorder [MDD], bipolar disorder [BD], schizophrenia [SZ], and schizoaffective disorder [SZA]) has been unable to identify diagnostic markers. An alternative approach is to study dimensional psychopathological syndromes that cut across categorical diagnoses. The aim of the current study was to identify gray matter volume (GMV) correlates of transdiagnostic symptom dimensions.
We tested the association of 5 psychopathological factors with GMV using multiple regression models in a sample of N = 1069 patients meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for MDD (n = 818), BD (n = 132), and SZ/SZA (n = 119). T1-weighted brain images were acquired with 3-Tesla magnetic resonance imaging and preprocessed with CAT12. Interactions analyses (diagnosis × psychopathological factor) were performed to test whether local GMV associations were driven by DSM-IV diagnosis. We further tested syndrome specific regions of interest (ROIs).
Whole brain analysis showed a significant negative association of the positive formal thought disorder factor with GMV in the right middle frontal gyrus, the paranoid-hallucinatory syndrome in the right fusiform, and the left middle frontal gyri. ROI analyses further showed additional negative associations, including the negative syndrome with bilateral frontal opercula, positive formal thought disorder with the left amygdala-hippocampus complex, and the paranoid-hallucinatory syndrome with the left angular gyrus. None of the GMV associations interacted with DSM-IV diagnosis.
We found associations between psychopathological syndromes and regional GMV independent of diagnosis. Our findings open a new avenue for neurobiological research across disorders, using syndrome-based approaches rather than categorical diagnoses.
一个多世纪以来，人们对主要精神疾病（重度抑郁症[MDD]、双相情感障碍[BD]、精神分裂症[SZ]和分裂情感性障碍[SZA]）的神经生物学基础进行了研究，但仍未能确定诊断标志物。另一种方法是研究跨越分类诊断的多维精神病理学综合征。本研究旨在确定跨诊断症状维度与灰质体积（GMV）的相关性。
我们使用多元回归模型，在符合DSM-IV 标准的 MDD（n=818）、BD（n=132）和 SZ/SZA（n=119）患者的样本中，测试了 5 种精神病理学因素与 GMV 的关联。采用 3T 磁共振成像采集 T1 加权脑图像，并使用 CAT12 进行预处理。进行交互分析（诊断×精神病理学因素）以检验 GMV 关联是否由 DSM-IV 诊断驱动。我们进一步测试了综合征特异性感兴趣区（ROI）。
全脑分析显示，阳性形式思维障碍因子与右侧额中回、偏执幻觉综合征与右侧梭状回以及左侧额中回的 GMV 呈显著负相关。ROI 分析进一步显示了其他负相关，包括阴性综合征与双侧额上回、阳性形式思维障碍与左侧杏仁核-海马复合体以及偏执幻觉综合征与左侧角回。GMV 关联均未与 DSM-IV 诊断相互作用。
我们发现精神病理学综合征与区域 GMV 之间存在关联，而与诊断无关。我们的研究结果为跨疾病的神经生物学研究开辟了新途径，采用综合征为基础的方法，而不是分类诊断。
