精神分裂症、分裂情感性障碍和伴有精神病性症状的双相I型障碍中脑结构与精神病症状维度之间的相关性。
Correlations between brain structure and symptom dimensions of psychosis in schizophrenia, schizoaffective, and psychotic bipolar I disorders.
作者信息
Padmanabhan Jaya L, Tandon Neeraj, Haller Chiara S, Mathew Ian T, Eack Shaun M, Clementz Brett A, Pearlson Godfrey D, Sweeney John A, Tamminga Carol A, Keshavan Matcheri S
机构信息
Department of Psychiatry, Beth Israel Deaconess Medical Center , Boston, MA; Division of Public Psychiatry, Massachusetts Mental Health Center , Boston, MA;
School of Social Work, Psychiatry, and Clinical and Translational Sciences Institute, University of Pittsburgh, Pittsburgh, PA; Western Psychiatric Institute and Clinic, Pittsburgh, PA;
出版信息
Schizophr Bull. 2015 Jan;41(1):154-62. doi: 10.1093/schbul/sbu075. Epub 2014 Jun 6.
INTRODUCTION
Structural alterations may correlate with symptom severity in psychotic disorders, but the existing literature on this issue is heterogeneous. In addition, it is not known how cortical thickness and cortical surface area correlate with symptom dimensions of psychosis.
METHODS
Subjects included 455 individuals with schizophrenia, schizoaffective, or bipolar I disorders. Data were obtained as part of the Bipolar Schizophrenia Network for Intermediate Phenotypes study. Diagnosis was made through the Structured Clinical Interview for DSM-IV. Positive and negative symptom subscales were assessed using the Positive and Negative Syndrome Scale. Structural brain measurements were extracted from T1-weight structural MRIs using FreeSurfer v5.1 and were correlated with symptom subscales using partial correlations. Exploratory factor analysis was also used to identify factors among those regions correlating with symptom subscales.
RESULTS
The positive symptom subscale correlated inversely with gray matter volume (GMV) and cortical thickness in frontal and temporal regions, whereas the negative symptom subscale correlated inversely with right frontal cortical surface area. Among regions correlating with the positive subscale, factor analysis identified four factors, including a temporal cortical thickness factor and frontal GMV factor. Among regions correlating with the negative subscale, factor analysis identified a frontal GMV-cortical surface area factor. There was no significant diagnosis by structure interactions with symptom severity.
CONCLUSIONS
Structural measures correlate with positive and negative symptom severity in psychotic disorders. Cortical thickness demonstrated more associations with psychopathology than cortical surface area.
引言
结构改变可能与精神障碍的症状严重程度相关，但关于这一问题的现有文献并不统一。此外，尚不清楚皮质厚度和皮质表面积与精神病症状维度之间如何关联。
方法
研究对象包括455名患有精神分裂症、分裂情感性障碍或双相I型障碍的个体。数据作为双相精神分裂症中间表型网络研究的一部分获得。通过《精神疾病诊断与统计手册》第四版（DSM-IV）的结构化临床访谈进行诊断。使用阳性和阴性症状量表评估阳性和阴性症状分量表。使用FreeSurfer v5.1从T1加权结构磁共振成像（MRI）中提取脑结构测量值，并使用偏相关分析将其与症状分量表进行关联。还采用探索性因素分析来识别与症状分量表相关的区域中的因素。
结果
阳性症状分量表与额叶和颞叶区域的灰质体积（GMV）和皮质厚度呈负相关，而阴性症状分量表与右侧额叶皮质表面积呈负相关。在与阳性分量表相关的区域中，因素分析确定了四个因素，包括一个颞叶皮质厚度因素和额叶GMV因素。在与阴性分量表相关的区域中，因素分析确定了一个额叶GMV-皮质表面积因素。结构与症状严重程度之间的相互作用没有显著的诊断差异。
结论
结构测量与精神障碍的阳性和阴性症状严重程度相关。与皮质表面积相比，皮质厚度与精神病理学的关联更多。
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