Romero Soledad, de la Serna Elena, Baeza Inmaculada, Valli Isabel, Pariente José Carlos, Picado Marisol, Bargalló Nuria, Sugranyes Gisela, Castro-Fornieles Josefina
Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic Barcelona, Barcelona, Spain.
Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
Front Psychiatry. 2022 May 10;13:876793. doi: 10.3389/fpsyt.2022.876793. eCollection 2022.
Disruption in white matter integrity has been consistently observed in individuals with psychosis. However, whether such abnormalities are already present at illness onset or are related to downstream processes remains elusive. The study of adolescents with a recent onset of psychosis provides the opportunity to evaluate white matter integrity proximally to disease onset.
Twenty-six adolescents (aged 15.9 ± 1.3 years) with a first episode of psychosis (FEP) (less than 6 months duration) were compared with 26 age and sex-matched healthy controls (HC) (16.8 ± 2 years). In participants with a FEP, clinical diagnoses were confirmed after a minimum of 1 year follow-up (main categories: schizophrenia, bipolar disorder, or schizoaffective disorder). Anatomical images and diffusion tensor sequences were acquired using a 1.5T scanner. Whole brain, voxel-wise group differences in fractional anisotropy (FA) were investigated between participants with a FEP and controls.
Relative to HC, FEP participants displayed decreased FA in the right posterior cingulate gyrus, encompassing the right superior and posterior corona radiata, and the right parahippocampal gyrus, including the cingulum and fornix. FEP patients showed no areas of increased FA relative to HC. The results remained significant after controlling for medication, cannabis use and intelligence.
Our findings indicate that adolescents with recent onset of psychotic disorders show decreased white matter integrity in circuits implicated in cognitive functions and emotion regulation.
在患有精神病的个体中，白质完整性受损一直是常见现象。然而，这种异常是在疾病发作时就已存在，还是与下游过程相关，目前仍不清楚。对近期发病的青少年精神病患者的研究，为在疾病发作初期评估白质完整性提供了机会。
将26名首次发作精神病（FEP）（病程少于6个月）的青少年（年龄15.9±1.3岁）与26名年龄和性别匹配的健康对照者（HC）（16.8±2岁）进行比较。对于FEP参与者，在至少1年的随访后确认临床诊断（主要类别：精神分裂症、双相情感障碍或分裂情感障碍）。使用1.5T扫描仪获取解剖图像和扩散张量序列。研究了FEP参与者与对照组之间全脑体素水平上的分数各向异性（FA）组间差异。
相对于HC，FEP参与者在右侧后扣带回、包括右侧放射冠上部和后部，以及右侧海马旁回、包括扣带和穹窿，FA降低。相对于HC，FEP患者未显示FA增加的区域。在控制药物使用、大麻使用和智力因素后，结果仍然显著。
我们的研究结果表明，近期发病的青少年精神病患者在涉及认知功能和情绪调节的神经回路中白质完整性降低。
