Department of Psychiatry, The Royal's Institute of Mental Health Research, University of Ottawa, Ottawa, ON, Canada.
Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, QC, Canada.
Schizophr Bull. 2021 Oct 21;47(6):1706-1717. doi: 10.1093/schbul/sbab071.
Brain-based Biotypes for psychotic disorders have been developed as part of the B-SNIP consortium to create neurobiologically distinct subgroups within idiopathic psychosis, independent from traditional phenomenological diagnostic methods. In the current study, we aimed to validate the Biotype model by assessing differences in volume and shape of the amygdala and hippocampus contrasting traditional clinical diagnoses with Biotype classification.
A total of 811 participants from 6 sites were included: probands with schizophrenia (n = 199), schizoaffective disorder (n = 122), psychotic bipolar disorder with psychosis (n = 160), and healthy controls (n = 330). Biotype classification, previously developed using cognitive and electrophysiological data and K-means clustering, was used to categorize psychosis probands into 3 Biotypes, with Biotype-1 (B-1) showing reduced neural salience and severe cognitive impairment. MAGeT-Brain segmentation was used to determine amygdala and hippocampal volumetric data and shape deformations.
When using Biotype classification, B-1 showed the strongest reductions in amygdala-hippocampal volume and the most widespread shape abnormalities. Using clinical diagnosis, probands with schizophrenia and schizoaffective disorder showed the most significant reductions of amygdala and hippocampal volumes and the most abnormal hippocampal shape compared with healthy controls. Biotype classification provided the strongest neuroanatomical differences compared with conventional DSM diagnoses, with the best discrimination seen using bilateral amygdala and right hippocampal volumes in B-1.
These findings characterize amygdala and hippocampal volumetric and shape abnormalities across the psychosis spectrum. Grouping individuals by Biotype showed greater between-group discrimination, suggesting a promising approach and a favorable target for characterizing biological heterogeneity across the psychosis spectrum.
基于大脑的精神病生物型是 B-SNIP 联盟开发的一部分，旨在为特发性精神病创造神经生物学上不同的亚组，与传统的现象学诊断方法无关。在目前的研究中，我们旨在通过比较传统的临床诊断与生物型分类来评估杏仁核和海马体的体积和形状差异来验证生物型模型。
共有来自 6 个地点的 811 名参与者入选：精神分裂症患者（n = 199）、分裂情感障碍患者（n = 122）、伴有精神病的双相情感障碍患者（n = 160）和健康对照组（n = 330）。生物型分类是使用认知和电生理数据以及 K-均值聚类预先开发的，用于将精神病患者分为 3 种生物型，其中 B-1 型表现出降低的神经显著性和严重的认知障碍。使用 MAGeT-Brain 分割来确定杏仁核和海马体的体积数据和形状变形。
使用生物型分类时，B-1 型显示出杏仁核-海马体体积降低最大和形状异常最广泛。使用临床诊断，与健康对照组相比，精神分裂症和分裂情感障碍患者的杏仁核和海马体体积下降最显著，海马体形状最异常。与传统的 DSM 诊断相比，生物型分类提供了最强的神经解剖差异，在 B-1 中使用双侧杏仁核和右侧海马体体积具有最佳的判别力。
这些发现描述了精神病谱中杏仁核和海马体的体积和形状异常。通过生物型对个体进行分组显示出更大的组间差异，这表明这是一种很有前途的方法，也是一种很有前途的方法，可以用于描述精神病谱中的生物学异质性。
