O'Neill Aisling, Dooley Niamh, Healy Colm, Carey Eleanor, Roddy Darren, Frodl Thomas, O'Hanlon Erik, Cannon Mary
Department of Psychiatry, Royal College of Surgeons Ireland, Dublin, Ireland.
Department of Psychology, Royal College of Surgeons Ireland, Dublin, Ireland.
Biol Psychiatry Glob Open Sci. 2022 Feb 17;3(2):264-273. doi: 10.1016/j.bpsgos.2022.02.003. eCollection 2023 Apr.
Gray matter abnormalities are observed across the psychosis spectrum. The trajectory of these abnormalities in healthy adolescents reporting subthreshold psychotic experiences (PEs) may provide insight into the neural mechanisms underlying psychotic symptoms. The risk of psychosis and additional psychopathology is even higher among these individuals who also report childhood adversity/DSM-5 diagnoses. Thus, the aims of this longitudinal study were to investigate PE-related volumetric changes in young people, noting any effects of childhood adversity/DSM-5 diagnosis.
A total of 211 young people 11 to 13 years of age participated in the initial Adolescent Brain Development study. PE classification was determined by expert consensus at each time point. Participants underwent neuroimaging at 3 time points over 6 years. A total of 76 participants with at least one scan were included in the final sample; 34 who met criteria for PEs at least once across all the time points (PE group) and 42 control subjects. Data from 20 bilateral regions of interest were extracted for linear mixed-effects analyses.
Right hippocampal volume increased over time in the control group, with no increase in the PE group ( .00352). DSM-5 diagnosis and childhood adversity were not significantly associated with right hippocampal volume. There was no significant effect of group or interaction in any other region.
These findings further implicate right hippocampal volumetric abnormalities in the pathophysiology underlying PEs. Furthermore, as suggested by previous studies in those at clinical high risk for psychosis and those with first-episode psychosis, it is possible that these deficits may be a marker for later clinical outcomes.
在整个精神病谱系中均观察到灰质异常。报告阈下精神病性体验(PEs)的健康青少年中这些异常的发展轨迹可能有助于深入了解精神病性症状背后的神经机制。在这些同时报告童年逆境/《精神疾病诊断与统计手册》第5版(DSM-5)诊断的个体中,患精神病和其他精神病理学的风险甚至更高。因此,这项纵向研究的目的是调查年轻人中与PE相关的体积变化,并注意童年逆境/DSM-5诊断的任何影响。
共有211名11至13岁的年轻人参与了最初的青少年大脑发育研究。每次通过专家共识确定PE分类。参与者在6年中的3个时间点接受了神经成像检查。最终样本包括至少有一次扫描的76名参与者;34名在所有时间点至少有一次符合PE标准的参与者(PE组)和42名对照受试者。提取来自20个双侧感兴趣区域的数据进行线性混合效应分析。
对照组右侧海马体积随时间增加,而PE组没有增加(.00352)。DSM-5诊断和童年逆境与右侧海马体积无显著相关性。在任何其他区域,组间或交互作用均无显著影响。
这些发现进一步表明右侧海马体积异常与PEs潜在的病理生理学有关。此外,正如先前对临床高危精神病患者和首发精神病患者的研究所表明的,这些缺陷可能是后期临床结果的一个标志。