Rapado-Castro Marta, Villar-Arenzana Mara, Janssen Joost, Fraguas David, Bombin Igor, Castro-Fornieles Josefina, Mayoral Maria, González-Pinto Ana, de la Serna Elena, Parellada Mara, Moreno Dolores, Paya Beatriz, Graell Montserrat, Baeza Inmaculada, Pantelis Christos, Arango Celso
Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, 28040 Madrid, Spain.
Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, 161 Barry Street, Carlton South, VIC 3053, Australia.
J Clin Med. 2021 Aug 31;10(17):3929. doi: 10.3390/jcm10173929.
Cognitive maturation during adolescence is modulated by brain maturation. However, it is unknown how these processes intertwine in early onset psychosis (EOP). Studies examining longitudinal brain changes and cognitive performance in psychosis lend support for an altered development of high-order cognitive functions, which parallels progressive gray matter (GM) loss over time, particularly in fronto-parietal brain regions. We aimed to assess this relationship in a subsample of 33 adolescents with first-episode EOP and 47 matched controls over 2 years. Backwards stepwise regression analyses were conducted to determine the association and predictive value of longitudinal brain changes over cognitive performance within each group. Fronto-parietal GM volume loss was positively associated with decreased working memory in adolescents with psychosis (frontal left (B = 0.096, = 0.008); right (B = 0.089, = 0.015); parietal left (B = 0.119, = 0.007), right (B = 0.125, = 0.015)) as a function of age. A particular decrease in frontal left GM volume best predicted a significant amount (22.28%) of the variance of decreased working memory performance over time, accounting for variance in age (14.9%). No such association was found in controls. Our results suggest that during adolescence, EOP individuals seem to follow an abnormal neurodevelopmental trajectory, in which fronto-parietal GM volume reduction is associated with the differential age-related working memory dysfunction in this group.
青春期的认知成熟受大脑成熟的调节。然而,在早发性精神病(EOP)中,这些过程是如何相互交织的尚不清楚。对精神病患者纵向大脑变化和认知表现的研究支持了高阶认知功能的发育改变,这与随着时间推移灰质(GM)的逐渐减少平行,尤其是在额顶叶脑区。我们旨在对33名首次发作EOP的青少年和47名匹配的对照组进行为期2年的抽样研究,以评估这种关系。进行向后逐步回归分析,以确定每组中纵向大脑变化与认知表现之间的关联和预测价值。在患有精神病的青少年中,额顶叶GM体积减少与工作记忆下降呈正相关(左侧额叶(B = 0.096,P = 0.008);右侧额叶(B = 0.089,P = 0.015);左侧顶叶(B = 0.119,P = 0.007),右侧顶叶(B = 0.125,P = 0.015)),且与年龄有关。左侧额叶GM体积的特别减少最能预测工作记忆表现随时间下降的显著方差量(22.28%),占年龄方差的14.9%。在对照组中未发现这种关联。我们的结果表明,在青春期,EOP个体似乎遵循异常的神经发育轨迹,其中额顶叶GM体积减少与该组中与年龄相关的工作记忆功能障碍差异有关。