期刊
SCHIZOPHRENIA BULLETIN
卷 38, 期 6, 页码 1268-1276出版社
OXFORD UNIV PRESS
DOI: 10.1093/schbul/sbr194
关键词
prodromal psychosis; schizophrenia; prefrontal cortex; dopamine; MRI; 18F-DOPA PET
类别
资金
- Brain & Behavior Research Foundation
- MRC [G0601437, MC_U120097115, G0700995] Funding Source: UKRI
- Medical Research Council [G0601437, G0700995, MC_U120097115, 1116129] Funding Source: researchfish
Background: People at ultra high risk (UHR) of psychosis have an elevated risk of developing a psychotic disorder, but it is difficult to predict which individuals will make a transition to frank illness. We investigated whether functional magnetic resonance imaging (fMRI) in conjunction with a phonological fluency task at presentation could distinguish subjects who subsequently developed psychosis from those who did not. Methods: Sixty-five subjects (41 with an UHR and 24 healthy controls) were assessed at clinical presentation using fMRI, in conjunction with a verbal fluency task. [18F]-DOPA positron emission tomography (PET) data were also available in a subgroup of 21 UHR and 14 healthy controls subjects. UHR subjects were followed clinically for at least 2 years. Results: Compared with UHR subjects who did not become psychotic, UHR subjects who subsequently developed psychosis showed increased activation in bilateral prefrontal cortex (PFC), brainstem (midbrain/basilar pons), the left hippocampus, and greater midbrain-PFC connectivity. Furthermore, exploratory analysis of [18F]-DOPA PET data showed that transition to psychosis was associated with elevated dopaminergic function in the brainstem region. Conclusions: In people at high risk of psychosis, increased activation in a network of cortical and subcortical regions may predict the subsequent onset of illness. Functional neuroimaging, in conjunction with clinical assessment and other investigations, may facilitate the prediction of outcome in subjects who are vulnerable to psychosis.
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