Marina Mihaljevic, Anisha Nagpal, Semra Etyemez, Zui Narita, Anna Ross, Rebecca Schaub, Nicola G Cascella, Jennifer M Coughlin, Gerald Nestadt, Frederik C Nucifora, Thomas W Sedlak, Vince D Calhoun, Andreia V Faria, Kun Yang, Akira Sawa
{"title":"早期精神病的神经影像学改变和复发。","authors":"Marina Mihaljevic, Anisha Nagpal, Semra Etyemez, Zui Narita, Anna Ross, Rebecca Schaub, Nicola G Cascella, Jennifer M Coughlin, Gerald Nestadt, Frederik C Nucifora, Thomas W Sedlak, Vince D Calhoun, Andreia V Faria, Kun Yang, Akira Sawa","doi":"10.1503/jpn.230115","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Recent reports have indicated that symptom exacerbation after a period of improvement, referred to as relapse, in early-stage psychosis could result in brain changes and poor disease outcomes. We hypothesized that substantial neuroimaging alterations may exist among patients who experience relapse in early-stage psychosis.</p><p><strong>Methods: </strong>We studied patients with psychosis within 2 years after the first psychotic event and healthy controls. We divided patients into 2 groups, namely those who did not experience relapse between disease onset and the magnetic resonance imaging (MRI) scan (no-relapse group) and those who did experience relapse between these 2 timings (relapse group). We analyzed 3003 functional connectivity estimates between 78 regions of interest (ROIs) derived from resting-state functional MRI data by adjusting for demographic and clinical confounding factors.</p><p><strong>Results: </strong>We studied 85 patients, incuding 54 in the relapse group and 31 in the no-relapse group, along with 94 healthy controls. We observed significant differences in 47 functional connectivity estimates between the relapse and control groups after multiple comparison corrections, whereas no differences were found between the no-relapse and control groups. Most of these pathological signatures (64%) involved the thalamus. The Jonckheere-Terpstra test indicated that all 47 functional connectivity changes had a significant cross-group progression from controls to patients in the no-relapse group to patients in the relapse group.</p><p><strong>Limitations: </strong>Longitudinal studies are needed to further validate the involvement and pathological importance of the thalamus in relapse.</p><p><strong>Conclusion: </strong>We observed pathological differences in neuronal connectivity associated with relapse in early-stage psychosis, which are more specifically associated with the thalamus. Our study implies the importance of considering neurobiological mechanisms associated with relapse in the trajectory of psychotic disorders.</p>","PeriodicalId":50073,"journal":{"name":"Journal of Psychiatry & Neuroscience","volume":"49 2","pages":"E135-E142"},"PeriodicalIF":4.1000,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10980532/pdf/","citationCount":"0","resultStr":"{\"title\":\"Neuroimaging alterations and relapse in early-stage psychosis.\",\"authors\":\"Marina Mihaljevic, Anisha Nagpal, Semra Etyemez, Zui Narita, Anna Ross, Rebecca Schaub, Nicola G Cascella, Jennifer M Coughlin, Gerald Nestadt, Frederik C Nucifora, Thomas W Sedlak, Vince D Calhoun, Andreia V Faria, Kun Yang, Akira Sawa\",\"doi\":\"10.1503/jpn.230115\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Recent reports have indicated that symptom exacerbation after a period of improvement, referred to as relapse, in early-stage psychosis could result in brain changes and poor disease outcomes. We hypothesized that substantial neuroimaging alterations may exist among patients who experience relapse in early-stage psychosis.</p><p><strong>Methods: </strong>We studied patients with psychosis within 2 years after the first psychotic event and healthy controls. We divided patients into 2 groups, namely those who did not experience relapse between disease onset and the magnetic resonance imaging (MRI) scan (no-relapse group) and those who did experience relapse between these 2 timings (relapse group). We analyzed 3003 functional connectivity estimates between 78 regions of interest (ROIs) derived from resting-state functional MRI data by adjusting for demographic and clinical confounding factors.</p><p><strong>Results: </strong>We studied 85 patients, incuding 54 in the relapse group and 31 in the no-relapse group, along with 94 healthy controls. We observed significant differences in 47 functional connectivity estimates between the relapse and control groups after multiple comparison corrections, whereas no differences were found between the no-relapse and control groups. Most of these pathological signatures (64%) involved the thalamus. The Jonckheere-Terpstra test indicated that all 47 functional connectivity changes had a significant cross-group progression from controls to patients in the no-relapse group to patients in the relapse group.</p><p><strong>Limitations: </strong>Longitudinal studies are needed to further validate the involvement and pathological importance of the thalamus in relapse.</p><p><strong>Conclusion: </strong>We observed pathological differences in neuronal connectivity associated with relapse in early-stage psychosis, which are more specifically associated with the thalamus. Our study implies the importance of considering neurobiological mechanisms associated with relapse in the trajectory of psychotic disorders.</p>\",\"PeriodicalId\":50073,\"journal\":{\"name\":\"Journal of Psychiatry & Neuroscience\",\"volume\":\"49 2\",\"pages\":\"E135-E142\"},\"PeriodicalIF\":4.1000,\"publicationDate\":\"2024-04-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10980532/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Psychiatry & Neuroscience\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1503/jpn.230115\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"Print\",\"JCR\":\"Q2\",\"JCRName\":\"NEUROSCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Psychiatry & Neuroscience","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1503/jpn.230115","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"Print","JCR":"Q2","JCRName":"NEUROSCIENCES","Score":null,"Total":0}
Neuroimaging alterations and relapse in early-stage psychosis.
Background: Recent reports have indicated that symptom exacerbation after a period of improvement, referred to as relapse, in early-stage psychosis could result in brain changes and poor disease outcomes. We hypothesized that substantial neuroimaging alterations may exist among patients who experience relapse in early-stage psychosis.
Methods: We studied patients with psychosis within 2 years after the first psychotic event and healthy controls. We divided patients into 2 groups, namely those who did not experience relapse between disease onset and the magnetic resonance imaging (MRI) scan (no-relapse group) and those who did experience relapse between these 2 timings (relapse group). We analyzed 3003 functional connectivity estimates between 78 regions of interest (ROIs) derived from resting-state functional MRI data by adjusting for demographic and clinical confounding factors.
Results: We studied 85 patients, incuding 54 in the relapse group and 31 in the no-relapse group, along with 94 healthy controls. We observed significant differences in 47 functional connectivity estimates between the relapse and control groups after multiple comparison corrections, whereas no differences were found between the no-relapse and control groups. Most of these pathological signatures (64%) involved the thalamus. The Jonckheere-Terpstra test indicated that all 47 functional connectivity changes had a significant cross-group progression from controls to patients in the no-relapse group to patients in the relapse group.
Limitations: Longitudinal studies are needed to further validate the involvement and pathological importance of the thalamus in relapse.
Conclusion: We observed pathological differences in neuronal connectivity associated with relapse in early-stage psychosis, which are more specifically associated with the thalamus. Our study implies the importance of considering neurobiological mechanisms associated with relapse in the trajectory of psychotic disorders.
期刊介绍：
The Journal of Psychiatry & Neuroscience publishes papers at the intersection of psychiatry and neuroscience that advance our understanding of the neural mechanisms involved in the etiology and treatment of psychiatric disorders. This includes studies on patients with psychiatric disorders, healthy humans, and experimental animals as well as studies in vitro. Original research articles, including clinical trials with a mechanistic component, and review papers will be considered.
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