Department of Electrical Engineering, Pontificia Universidad Catolica de Chile, Santiago, Chile.
Biomedical Imaging Center, Pontificia Universidad Catolica de Chile, Santiago, Chile.
Schizophr Bull. 2023 Sep 7;49(5):1355-1363. doi: 10.1093/schbul/sbad041.
BACKGROUND: Psychosis is related to neurochemical changes in deep-brain nuclei, particularly suggesting dopamine dysfunctions. We used an magnetic resonance imaging-based technique called quantitative susceptibility mapping (QSM) to study these regions in psychosis. QSM quantifies magnetic susceptibility in the brain, which is associated with iron concentrations. Since iron is a cofactor in dopamine pathways and co-localizes with inhibitory neurons, differences in QSM could reflect changes in these processes. METHODS: We scanned 83 patients with first-episode psychosis and 64 healthy subjects. We reassessed 22 patients and 21 control subjects after 3 months. Mean susceptibility was measured in 6 deep-brain nuclei. Using linear mixed models, we analyzed the effect of case-control differences, region, age, gender, volume, framewise displacement (FD), treatment duration, dose, laterality, session, and psychotic symptoms on QSM. RESULTS: Patients showed a significant susceptibility reduction in the putamen and globus pallidus externa (GPe). Patients also showed a significant R2* reduction in GPe. Age, gender, FD, session, group, and region are significant predictor variables for QSM. Dose, treatment duration, and volume were not predictor variables of QSM. CONCLUSIONS: Reduction in QSM and R2* suggests a decreased iron concentration in the GPe of patients. Susceptibility reduction in putamen cannot be associated with iron changes. Since changes observed in putamen and GPe were not associated with symptoms, dose, and treatment duration, we hypothesize that susceptibility may be a trait marker rather than a state marker, but this must be verified with long-term studies.
背景:精神病与深部脑核的神经化学变化有关,尤其是多巴胺功能障碍。我们使用一种基于磁共振成像的技术,称为定量磁化率映射(QSM),来研究精神病中的这些区域。QSM 定量测量大脑的磁化率,磁化率与铁浓度有关。由于铁是多巴胺途径的辅助因子,并且与抑制性神经元共存,QSM 的差异可能反映了这些过程的变化。
方法:我们扫描了 83 名首发精神病患者和 64 名健康受试者。我们在 3 个月后重新评估了 22 名患者和 21 名对照受试者。在 6 个深部脑核中测量了平均磁化率。我们使用线性混合模型分析了病例对照差异、区域、年龄、性别、体积、框架位移(FD)、治疗持续时间、剂量、偏侧性、会话和精神病症状对 QSM 的影响。
结果:患者的壳核和苍白球外(GPe)的磁化率显著降低。患者的 GPe 的 R2*也显著降低。年龄、性别、FD、会话、组别和区域是 QSM 的显著预测变量。剂量、治疗持续时间和体积不是 QSM 的预测变量。
结论:GPe 中的 QSM 和 R2*降低提示铁浓度降低。壳核的磁化率降低不能与铁变化相关联。由于在壳核和 GPe 中观察到的变化与症状、剂量和治疗持续时间无关,我们假设磁化率可能是一种特征标志物,而不是一种状态标志物,但这必须通过长期研究来验证。
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