皮质表面异常因精神分裂症的阶段而异：厚度、面积和脑回容积的跨阶段顶点mega 分析。

Cortical surface abnormalities are different depending on the stage of schizophrenia: A cross-sectional vertexwise mega-analysis of thickness, area and gyrification.

机构信息

Laboratory of Psychiatric Neuroimaging (LIM-21), Departamento e Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.

Laboratory of Integrated Neurosciences (LiNC), Department of Psychiatry, Escola Paulista de Medicina, Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, Brazil; Schizophrenia Program (PROESQ), Department of Psychiatry, Escola Paulista de Medicina, Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents (CNPq), Sao Paulo, Brazil.

出版信息

Schizophr Res. 2021 Oct;236:104-114. doi: 10.1016/j.schres.2021.08.011. Epub 2021 Sep 1.

DOI:10.1016/j.schres.2021.08.011

PMID:34481405

Abstract

BACKGROUND

Brain magnetic resonance imaging studies have not investigated the cortical surface comprehensively in schizophrenia subjects by assessing thickness, surface area and gyrification separately during the first-episode of psychosis (FEP) or chronic schizophrenia (ChSch).

METHODS

We investigated cortical surface abnormalities in 137 FEP patients and 240 ChSch subjects compared to 297 Healthy Controls (HC) contributed by five cohorts. Maps showing results of vertexwise between-group comparisons of cortical thickness, area, and gyrification were produced using T1-weighted datasets processed using FreeSurfer 5.3, followed by validated quality control protocols.

RESULTS

FEP subjects showed large clusters of increased area and gyrification relative to HC in prefrontal and insuli cortices (Cohen's d: 0.049 to 0.28). These between-group differences occurred partially beyond the effect of sample. ChSch subjects displayed reduced cortical thickness relative to HC in smaller fronto-temporal foci (d: -0.73 to -0.35), but not beyond the effect of sample. Differences between FEP and HC subjects were associated with male gender, younger age, and earlier illness onset, while differences between ChSch and HC were associated with treatment-resistance and first-generation antipsychotic (FGA) intake independently of sample effect.

CONCLUSIONS

Separate assessments of FEP and ChSch revealed abnormalities that differed in regional distribution, phenotypes affected and effect size. In FEP, associations of greater cortical area and gyrification abnormalities with earlier age of onset suggest an origin on anomalous neurodevelopment, while thickness reductions in ChSch are at least partially explained by treatment-resistance and FGA intake. Associations of between-group differences with clinical variables retained statistical significance beyond the effect of sample.

摘要

背景

脑磁共振成像研究尚未在首发精神分裂症（FEP）或慢性精神分裂症（ChSch）患者中全面评估皮质表面，分别评估厚度、表面积和脑回。

方法

我们调查了 137 名 FEP 患者和 240 名 ChSch 患者与 297 名健康对照组（HC）之间的皮质表面异常，这些对照组由五个队列组成。使用 T1 加权数据集生成显示皮质厚度、面积和脑回之间组间比较结果的顶点图，这些数据集使用 FreeSurfer 5.3 进行处理，并遵循经过验证的质量控制协议。

结果

与 HC 相比，FEP 患者在前额叶和岛叶皮质中表现出大面积的面积和脑回增加（Cohen's d：0.049 至 0.28）。这些组间差异部分超出了样本的影响。与 HC 相比，ChSch 患者在较小的额颞焦点处表现出皮质厚度减少（d：-0.73 至-0.35），但未超出样本的影响。FEP 和 HC 之间的差异与男性性别、年龄较小和发病较早有关，而 ChSch 和 HC 之间的差异与治疗抵抗和第一代抗精神病药物（FGA）摄入独立于样本效应有关。

结论

对 FEP 和 ChSch 的单独评估显示，异常在区域分布、受影响的表型和效应大小上有所不同。在 FEP 中，皮质面积和脑回异常增加与发病年龄较早的相关性表明其起源于异常神经发育，而 ChSch 中的厚度减少至少部分由治疗抵抗和 FGA 摄入解释。组间差异与临床变量之间的关联在样本效应之外仍具有统计学意义。