Division of Psychiatry, Institute of Mental Health, University College London, London, UK.
The Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff University, Cardiff, UK.
Mol Psychiatry. 2023 Sep;28(9):3688-3697. doi: 10.1038/s41380-023-02295-6. Epub 2023 Oct 30.
Psychotic experiences (PEs) occur in 5-10% of the general population and are associated with exposure to childhood trauma and obstetric complications. However, the neurobiological mechanisms underlying these associations are unclear. Using the Avon Longitudinal Study of Parents and Children (ALSPAC), we studied 138 young people aged 20 with PEs (n = 49 suspected, n = 53 definite, n = 36 psychotic disorder) and 275 controls. Voxel-based morphometry assessed whether MRI measures of grey matter volume were associated with (i) PEs, (ii) cumulative childhood psychological trauma (weighted summary score of 6 trauma types), (iii) cumulative pre/peri-natal risk factors for psychosis (weighted summary score of 16 risk factors), and (iv) the interaction between PEs and cumulative trauma or pre/peri-natal risk. PEs were associated with smaller left posterior cingulate (pFWE < 0.001, Z = 4.19) and thalamus volumes (pFWE = 0.006, Z = 3.91). Cumulative pre/perinatal risk was associated with smaller left subgenual cingulate volume (pFWE < 0.001, Z = 4.54). A significant interaction between PEs and cumulative pre/perinatal risk found larger striatum (pFWE = 0.04, Z = 3.89) and smaller right insula volume extending into the supramarginal gyrus and superior temporal gyrus (pFWE = 0.002, Z = 4.79), specifically in those with definite PEs and psychotic disorder. Cumulative childhood trauma was associated with larger left dorsal striatum (pFWE = 0.002, Z = 3.65), right prefrontal cortex (pFWE < 0.001, Z = 4.63) and smaller left insula volume in all participants (pFWE = 0.03, Z = 3.60), and there was no interaction with PEs group. In summary, pre/peri-natal risk factors and childhood psychological trauma impact similar brain pathways, namely smaller insula and larger striatum volumes. The effect of pre/perinatal risk was greatest in those with more severe PEs, whereas effects of trauma were seen in all participants. In conclusion, environmental risk factors affect brain networks implicated in schizophrenia, which may increase an individual's propensity to develop later psychotic disorders.
精神病性体验（PEs）在普通人群中发生率为 5-10%，与儿童期创伤和产科并发症暴露有关。然而，这些关联的神经生物学机制尚不清楚。本研究使用阿冯纵向父母和儿童研究（ALSPAC），研究了 20 岁时有 PEs 的 138 名年轻人（可疑 PEs49 例，明确 PEs53 例，精神病性障碍 36 例）和 275 名对照。基于体素的形态测量学评估了 MRI 测量的灰质体积是否与以下因素有关：（i）PEs，（ii）累积儿童期心理创伤（6 种创伤类型的加权综合评分），（iii）累积产前/围产期精神病风险因素（16 种风险因素的加权综合评分），以及（iv）PEs 与累积创伤或产前/围产期风险之间的相互作用。PEs 与左侧后扣带回（pFWE<0.001，Z=4.19）和丘脑体积较小有关（pFWE=0.006，Z=3.91）。累积产前/围产期风险与左侧扣带回下脚较小有关（pFWE<0.001，Z=4.54）。PEs 和累积产前/围产期风险之间存在显著的相互作用，发现纹状体较大（pFWE=0.04，Z=3.89），右侧岛叶体积较小，延伸至缘上回和颞上回（pFWE=0.002，Z=4.79），特别是在明确 PEs 和精神病性障碍患者中。累积儿童期创伤与左侧背侧纹状体较大（pFWE=0.002，Z=3.65）、右侧前额叶皮层（pFWE<0.001，Z=4.63）和所有参与者的左侧岛叶体积较小有关（pFWE=0.03，Z=3.60），且与 PEs 组之间无相互作用。总之，产前/围产期风险因素和儿童期心理创伤影响相似的脑通路，即岛叶和纹状体体积较小。在 PEs 更严重的患者中，产前/围产期风险的影响最大，而创伤的影响在所有参与者中都存在。总之，环境风险因素影响精神分裂症相关的脑网络，这可能会增加个体日后出现精神病性障碍的倾向。
