Tognin Stefania, Richter Anja, Kempton Matthew J, Modinos Gemma, Antoniades Mathilde, Azis Matilda, Allen Paul, Bossong Matthijs G, Perez Jesus, Pantelis Christos, Nelson Barnaby, Amminger Paul, Riecher-Rössler Anita, Barrantes-Vidal Neus, Krebs Marie-Odile, Glenthøj Birte, Ruhrmann Stephan, Sachs Gabriele, Rutten Bart P F, de Haan Lieuwe, van der Gaag Mark, Valmaggia Lucia R, McGuire Philip
Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.
CAMEO Early Intervention in Psychosis Services, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK.
Schizophr Bull Open. 2022 Jun 20;3(1):sgac040. doi: 10.1093/schizbullopen/sgac040. eCollection 2022 Jan.
To examine the association between baseline alterations in grey matter volume (GMV) and clinical and functional outcomes in people at clinical high risk (CHR) for psychosis.
265 CHR individuals and 92 healthy controls were recruited as part of a prospective multi-center study. After a baseline assessment using magnetic resonance imaging (MRI), participants were followed for at least two years to determine clinical and functional outcomes, including transition to psychosis (according to the Comprehensive Assessment of an At Risk Mental State, CAARMS), level of functioning (according to the Global Assessment of Functioning), and symptomatic remission (according to the CAARMS). GMV was measured in selected cortical and subcortical regions of interest (ROI) based on previous studies (ie orbitofrontal gyrus, cingulate gyrus, gyrus rectus, inferior temporal gyrus, parahippocampal gyrus, striatum, and hippocampus). Using voxel-based morphometry, we analysed the relationship between GMV and clinical and functional outcomes.
Within the CHR sample, a poor functional outcome (GAF < 65) was associated with relatively lower GMV in the right striatum at baseline ( < .047 after Family Wise Error correction). There were no significant associations between baseline GMV and either subsequent remission or transition to psychosis.
In CHR individuals, lower striatal GMV was associated with a poor level of overall functioning at follow-up. This finding was not related to effects of antipsychotic or antidepressant medication. The failure to replicate previous associations between GMV and later psychosis onset, despite studying a relatively large sample, is consistent with the findings of recent large-scale multi-center studies.
研究临床高危（CHR）精神病患者的灰质体积（GMV）基线改变与临床及功能结局之间的关联。
作为一项前瞻性多中心研究的一部分，招募了265名CHR个体和92名健康对照者。在使用磁共振成像（MRI）进行基线评估后，对参与者进行了至少两年的随访，以确定临床和功能结局，包括向精神病的转变（根据高危精神状态综合评估，CAARMS）、功能水平（根据功能综合评定量表）和症状缓解（根据CAARMS）。基于先前的研究（即眶额回、扣带回、直回、颞下回、海马旁回、纹状体和海马），在选定的皮质和皮质下感兴趣区域（ROI）测量GMV。使用基于体素的形态学方法，我们分析了GMV与临床和功能结局之间的关系。
在CHR样本中，功能结局较差（GAF<65）与基线时右侧纹状体相对较低的GMV相关（家族性错误校正后P<0.047）。基线GMV与随后的缓解或向精神病的转变之间均无显著关联。
在CHR个体中，较低的纹状体GMV与随访时较差的整体功能水平相关。这一发现与抗精神病药或抗抑郁药无关。尽管研究样本相对较大，但未能重复先前GMV与后期精神病发作之间的关联，这与最近大规模多中心研究的结果一致。
