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精神分裂症和双相情感障碍遗传风险儿童和青少年的视网膜功能和临床前风险特征。

Retinal function and preclinical risk traits in children and adolescents at genetic risk of schizophrenia and bipolar disorder.

机构信息

CERVO Brain Research Center, Centre intégré universitaire de santé et des services sociaux de la Capitale-Nationale, Québec, Canada; Université Laval, Faculté de Médecine, Département de psychiatrie et neurosciences, Québec, Canada.

CERVO Brain Research Center, Centre intégré universitaire de santé et des services sociaux de la Capitale-Nationale, Québec, Canada; Université Laval, Faculté de Médecine, Département de médecine sociale et préventive, Québec, Canada.

出版信息

Prog Neuropsychopharmacol Biol Psychiatry. 2022 Jan 10;112:110432. doi: 10.1016/j.pnpbp.2021.110432. Epub 2021 Aug 27.

Abstract

BACKGROUND

The millions of children having a parent affected by a major psychiatric disorder may carry, as vulnerability indicators, electroretinographic (ERG) anomalies resembling those seen in adult patients. Our goal was to determine whether ERG anomalies in high-risk youths are related to clinical precursors of a later transition to illness such as the presence of childhood DSM-IV diagnoses, bouts of psychotic like experiences, lower global IQ and social functioning deterioration.

METHODS

The 99 youths (53% males) aged 5-27 years had one parent affected by schizophrenia, bipolar disorder or major depressive disorder. They were assessed with a best-estimate DSM-IV diagnoses based on review of medical charts and a structured interview (K-SADS or SCID), global IQ (WISC-V and WAIS-IV), global functioning (GAF scale) and psychotic-like experiences using interviews and a review of medical records. The electroretinogram of rods and cones was recorded.

RESULTS

Cone Vmax latency was longer in offspring having psychotic-like experiences, respective adjusted mean [SE] ms of 31.59 [0.27] and of 30.96 [0.14]; P = 0.018). The cone Vmax delayed latency was associated with a lower global IQ (R = -0.18; P = 0.045) and with deteriorated global functioning (GAF; R = -0.25; P = 0.008). In contrast, rods had decreased b-wave amplitude only in offspring with a non-psychotic non-affective DSM diagnoses, respective means [SE] μV of 170.18 [4.90] and of 184.01 [6.12]; P = 0.044).

CONCLUSIONS

ERG may mark neurodevelopmental pathways leading to adult illness and have an effect on early pre-clinical traits, giving clues to clinicians for the surveillance of sibling differences in high-risk families.

摘要

背景

患有主要精神障碍的父母的数百万子女可能具有与成年患者相似的视网膜电图 (ERG) 异常,这些异常可能是易感性指标。我们的目标是确定高危青少年的 ERG 异常是否与后来发病的临床前兆有关,例如存在儿童 DSM-IV 诊断、类似精神病的发作、较低的整体智商和社会功能下降。

方法

99 名年龄在 5-27 岁的年轻人(53%为男性)的父母中有一人患有精神分裂症、双相情感障碍或重性抑郁障碍。他们根据病历回顾和结构化访谈(K-SADS 或 SCID)进行最佳估计 DSM-IV 诊断,并进行整体智商(WISC-V 和 WAIS-IV)、整体功能(GAF 量表)和使用访谈和病历回顾进行精神病样体验评估。记录了视杆和视锥细胞的视网膜电图。

结果

有精神病样体验的子女视锥细胞 Vmax 潜伏期较长,分别为 31.59 [0.27] 和 30.96 [0.14];P=0.018)。视锥细胞 Vmax 延迟潜伏期与较低的整体智商(R=-0.18;P=0.045)和整体功能下降(GAF;R=-0.25;P=0.008)有关。相比之下,只有在无精神病非情感性 DSM 诊断的子女中,视杆的 b 波振幅才会降低,分别为 170.18 [4.90] 和 184.01 [6.12];P=0.044)。

结论

ERG 可能标志着导致成年疾病的神经发育途径,并对早期临床前特征产生影响,为临床医生监测高危家庭中兄弟姐妹之间的差异提供线索。

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