基于磁共振脑功能评估的精神病临床高危转归研究

The stage of clinical high-risk for psychosis is a critical time window for approaching the onset of schizophrenia. However, the individual development trajectory of CHR is heterogeneous, which means only part of CHR will go on to develop psychosis. The widespread use of antipsychotics may bring about stigma and unnecessary side effects. It was found that the individual trajectories of CHR with different outcomes (transition and remission) had neuroimaging differences, so it was suggested that abnormal brain function of magnetic resonance imaging could be used as neuroimaging markers for different outcomes of CHR..In this research, we will collect multimodal MRI data of CHR and healthy controls, including sMRI, rsfMRI and DTI, to observe the defective features of CHR in morphology, functional connectivity and structural connectivity. And according to follow up individual outcomes, we will find the brain structure and function differences in transformed group, persistent symptom group and remission group to explore the neuroimaging markers of different outcomes of CHR, to screen the key brain regions or brain networks of psychiatric transition, to accurately identify the CHR individuals who may develop into schizophrenia and determine the markers of brain dysfunction related to transition, so as to provide evidence for elucidating the early biological abnormalities of the disease and the neuroimaging mechanism of predicting different outcomes, and lay the foundation for CHR targeted neuromodulation skill.

精神病临床高危（CHR）阶段是接近精神分裂症疾病发作的关键时间窗。但CHR个体发展轨迹存在异质性，转归不同，只有部分转化，抗精神病药的广泛使用可能带来病耻感和不必要承受的副作用。研究发现不同转归（转化和缓解）的CHR个体轨迹存在影像学差异，故提出磁共振脑功能异常可作为精神病临床高危不同转归的影像标志。本项目通过收集CHR与健康对照的多模态磁共振数据进行研究，即结构磁共振成像、静息态功能磁共振成像、弥散张量成像，观察CHR在形态学、局部指标、功能连接和结构连接方面的缺陷特点；同时随访个体转归，通过对转化组、持续症状组和缓解组脑结构和功能的比较，探索CHR不同转归的脑影像标志物，筛选精神病转化的关键脑区或脑网络，准确的识别真正可能发展为精神分裂症的CHR个体并确定与转变有关的磁共振脑功能异常指标，为阐明疾病早期生物学异常和预测转归的神经影像机制提供依据，并为CHR神经调控靶向干预奠定基础。

项目背景：精神病临床高危（CHR）阶段是接近精神分裂症疾病发作的关键时间窗。但CHR个体发展轨迹存在异质性。研究发现不同转归（转化和缓解）的CHR个体轨迹存在影像学差异，故提出磁共振脑功能异常可作为精神病临床高危不同转归的影像标志。研究内容：本项目通过收集CHR与健康对照的多模态磁共振数据进行研究，即结构磁共振成像、静息态功能磁共振成像、弥散张量成像，观察CHR在形态学、局部指标、功能连接和结构连接方面的缺陷特点；同时随访个体转归，通过对转化组、持续症状组和缓解组脑结构和功能的比较，探索CHR不同转归的脑影像标志物，筛选精神病转化的关键脑区或脑网络。重要结果：静息态功能磁共振成像：静息状态下早期精神病（包括CHR、首发精神分裂症）突显网络与高级认知网络、感觉网络的功能交互异常，突显-高级认知脑网络、突显-感觉脑网络拓扑属性发生了方向完全相反改变。灰质结构磁共振成像：CHR的左枕叶皮层厚度较HC变薄，CHR的额叶、顶叶脑区的皮层厚度则较精神分裂症组增厚；CHR组在额叶、岛叶脑区灰质体积较精神分裂症组增厚。弥散张量成像：CHR的额叶及边缘叶纤维束连接异常，表现为白质完整性降低、髓鞘受损、纤维密度降低及炎症反应。科学意义：为阐明疾病早期生物学异常和预测转归的神经影像机制提供依据，并为CHR神经调控靶向干预奠定基础。