异常皮质抑制与临床精神病高危患者临床预后的关系

IF 3.7 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology Pub Date : 2024-12-01 DOI:10.1016/j.clinph.2024.11.015

Guanfu Wu , Tianyuan Zhu , Chunyan Ma , Lihua Xu , Zhenying Qian , Gai Kong , Huiru Cui , Tianhong Zhang , Jijun Wang , Yingying Tang

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引用次数: 0

摘要

目的经颅磁刺激（TMS）可在体内检测皮质抑制（CI），精神分裂症患者存在皮质抑制异常。然而，异常CI是否发生在临床精神病高危患者（CHR）的早期，或者是否可以预测其临床结局，目前尚不清楚。方法我们测量了55例CHR、35例首发精神分裂症（FES）和35例健康对照（HC）的运动皮层的短间隔皮质抑制（SICI）、皮质沉默期（CSP）和皮质内促进（ICF）和神经认知表现。我们根据两年随访期间的临床结果将CHR患者分为CHR转化者（CHR- c）和CHR非转化者（CHR- nc）。结果CHR-C组scsp （P = 0.033）和FES组scsp （P = 0.047）较HC组长，而CHR-NC组和HC组CSP具有可比性。在CHR中，CSP在符号编码和迷宫任务中的表现呈负相关。SICI和ICF组间无显著差异。结论gabab介导的CSP在CHR中延长，并与较差的神经认知功能相关。CSP在精神病发作前会延长，尤其是在chrc患者中，这表明CSP可能是预测向精神分裂症过渡的潜在生物标志物。

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Association of abnormal cortical inhibition and clinical outcomes in patients at clinical high risk for psychosis

Objective

Cortical inhibition (CI) can be in-vivo measured using transcranial magnetic stimulation (TMS), and patients with schizophrenia had abnormal CI. However, whether the abnormal CI occur early in patients with clinical high risk for psychosis (CHR) or could predict their clinical outcomes remains less known.

Methods

We measured short-interval cortical inhibition (SICI), cortical silent period (CSP), and intra-cortical facilitation (ICF) over the motor cortex and neurocognitive performances in 55 CHR, 35 first-episode schizophrenia (FES), and 35 healthy controls (HC). We divided CHR patients into CHR converters (CHR-C) and CHR non-converters (CHR-NC) according to their clinical outcomes within the two-year follow-up.

Results

CSP was longer in CHR-C (P = 0.033) and FES (P = 0.047) than in HC, while CSP was comparable between CHR-NC and HC. In CHR, CSP was negatively related to their performances in symbol coding and maze tasks. There was no significant between-group difference for either SICI or ICF.

Conclusions

Our findings suggested GABA_B-mediated CSP was prolonged in CHR, who later converted into schizophrenia, and was associated with poor neurocognitive functions.

Significance

CSP is prolonged before the onset of psychosis, particularly in CHR-C patients, suggesting that CSP could be a potential biomarker for predicting transition to schizophrenia.

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来源期刊

Clinical Neurophysiology 医学-临床神经学

CiteScore

8.70

自引率

6.40%

发文量

932

审稿时长

59 days

期刊介绍： As of January 1999, The journal Electroencephalography and Clinical Neurophysiology, and its two sections Electromyography and Motor Control and Evoked Potentials have amalgamated to become this journal - Clinical Neurophysiology. Clinical Neurophysiology is the official journal of the International Federation of Clinical Neurophysiology, the Brazilian Society of Clinical Neurophysiology, the Czech Society of Clinical Neurophysiology, the Italian Clinical Neurophysiology Society and the International Society of Intraoperative Neurophysiology.The journal is dedicated to fostering research and disseminating information on all aspects of both normal and abnormal functioning of the nervous system. The key aim of the publication is to disseminate scholarly reports on the pathophysiology underlying diseases of the central and peripheral nervous system of human patients. Clinical trials that use neurophysiological measures to document change are encouraged, as are manuscripts reporting data on integrated neuroimaging of central nervous function including, but not limited to, functional MRI, MEG, EEG, PET and other neuroimaging modalities.