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Longitudinal changes of local gyrification index in schizophrenia spectrum disorders

PHAM Viet Tien 富山大学

2022.03.23

概要

〔目的〕
Previous magnetic resonance imaging (MRI) studies reported increased brain gyrification in schizophrenia and schizotypal disorder, a prototypic disorder within the schizophrenia spectrum, possibly reflecting deviations in early neurodevelopment. However, it currently remains unclear whether the gyrification pattern longitudinally changes over the course of the schizophrenia spectrum.

〔方法並びに成績〕
Longitudinal MRI scans were obtained by a 1.5-T scanner from 23 patients with first-episode schizophrenia, 14 patients with schizotypal disorder, and 39 healthy subjects. Using FreeSurfer software, the local gyrification index (LGI) of entire cortex was obtained at baseline and follow-up scans (mean interscan interval = 2.7 years). Clinical symptoms were rated using the Scale for the Assessment of Positive and Negative Symptoms (SAPS/SANS) at the time of scanning. A general linear model was used for crosssectional and longitudinal group comparisons of the LGI and for whole brain LGI correlation analyses with clinical variables. This study was approved by the Committee on the Medical Ethics of Toyama University based on the declaration of Helsinki. Written informed consent was obtained from all subjects.

Baseline comparison demonstrated increased LGI of the frontal regions in the schizotypal but not in schizophrenia groups compared to controls. The schizophrenia group exhibited progressive LGI reduction predominantly in the fronto-temporal regions, while the LGIs were increased over time in the schizotypal and control groups in several brain regions. Longitudinal group comparison demonstrated that LGI increase over time was greater in the healthy subjects compared with schizotypal patients in the left frontal regions. In the schizophrenia group, greater LGI reduction over time in the right precentral and postcentral regions was significantly associated with less improvement of negative symptoms. Cumulative medication dosage was negatively correlated with longitudinal LGI increase in the right superior parietal area in the schizotypal group, but it did not affect the longitudinal LGI changes in schizophrenia group.

〔総括〕
This study demonstrated LGI reduction over time predominantly in the frontal and temporal areas during early phases of schizophrenia, which was partly associated with less improvement of negative symptoms. In contrast, the schizotypal patients showed increased LGI at baseline but showed no longitudinal LGI reduction. Thus, the gyrification patterns in schizophrenia spectrum may reflect both early neurodevelopmental abnormality as a vulnerability factor and active brain pathology in the early stages of schizophrenia.

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