Development of the craniofacies occurs in embryological intimacy with development of the brain and both show normal left-right asymmetries. While facial dysmorphology occurs to excess in psychotic illness, facial asymmetry has yet to be investigated as a putative index of brain asymmetry. Ninety-three subjects (49 controls, 22 schizophrenia, 22 bipolar disorder) received 3D laser surface imaging of the face. On geometric morphometric analysis with (x, y, z) visualisations of statistical models for facial asymmetries, in controls the upper face and periorbital region, which share embryological intimacy with the forebrain, showed marked asymmetries. Their geometry included: along the x-axis, rightward asymmetry in its dorsal-medial aspects and leftward asymmetry in its ventral-lateral aspects; along the z-axis, anterior protrusion in its right ventral-lateral aspect. In both schizophrenia and bipolar disorder these normal facial asymmetries were diminished, with residual retention of asymmetries in bipolar disorder. This geometry of normal facial asymmetries shows commonalities with that of normal frontal lobe asymmetries. These findings indicate a trans-diagnostic process that involves loss of facial asymmetries in both schizophrenia and bipolar disorder. Embryologically, they implicate loss of face-brain asymmetries across gestational weeks 7-14 in processes that involve genes previously associated with risk for schizophrenia.
- MeSH
- asymetrie obličeje * diagnostické zobrazování patologie MeSH
- bipolární porucha * diagnostické zobrazování patologie MeSH
- dospělí MeSH
- funkční lateralita fyziologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mozek diagnostické zobrazování patologie MeSH
- obličej MeSH
- psychotické poruchy diagnostické zobrazování patologie MeSH
- schizofrenie * diagnostické zobrazování patologie MeSH
- zobrazování trojrozměrné MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Machine learning can be used to define subtypes of psychiatric conditions based on shared biological foundations of mental disorders. Here we analyzed cross-sectional brain images from 4,222 individuals with schizophrenia and 7038 healthy subjects pooled across 41 international cohorts from the ENIGMA, non-ENIGMA cohorts and public datasets. Using the Subtype and Stage Inference (SuStaIn) algorithm, we identify two distinct neurostructural subgroups by mapping the spatial and temporal 'trajectory' of gray matter change in schizophrenia. Subgroup 1 was characterized by an early cortical-predominant loss with enlarged striatum, whereas subgroup 2 displayed an early subcortical-predominant loss in the hippocampus, striatum and other subcortical regions. We confirmed the reproducibility of the two neurostructural subtypes across various sample sites, including Europe, North America and East Asia. This imaging-based taxonomy holds the potential to identify individuals with shared neurobiological attributes, thereby suggesting the viability of redefining existing disorder constructs based on biological factors.
- MeSH
- algoritmy * MeSH
- dospělí MeSH
- hipokampus diagnostické zobrazování patologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční tomografie * MeSH
- mozek diagnostické zobrazování patologie MeSH
- neurozobrazování MeSH
- průřezové studie MeSH
- reprodukovatelnost výsledků MeSH
- schizofrenie * diagnostické zobrazování patologie MeSH
- šedá hmota * diagnostické zobrazování patologie MeSH
- strojové učení MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Evropa MeSH
- Severní Amerika MeSH
Multivariate techniques better fit the anatomy of complex neuropsychiatric disorders which are characterized not by alterations in a single region, but rather by variations across distributed brain networks. Here, we used principal component analysis (PCA) to identify patterns of covariance across brain regions and relate them to clinical and demographic variables in a large generalizable dataset of individuals with bipolar disorders and controls. We then compared performance of PCA and clustering on identical sample to identify which methodology was better in capturing links between brain and clinical measures. Using data from the ENIGMA-BD working group, we investigated T1-weighted structural MRI data from 2436 participants with BD and healthy controls, and applied PCA to cortical thickness and surface area measures. We then studied the association of principal components with clinical and demographic variables using mixed regression models. We compared the PCA model with our prior clustering analyses of the same data and also tested it in a replication sample of 327 participants with BD or schizophrenia and healthy controls. The first principal component, which indexed a greater cortical thickness across all 68 cortical regions, was negatively associated with BD, BMI, antipsychotic medications, and age and was positively associated with Li treatment. PCA demonstrated superior goodness of fit to clustering when predicting diagnosis and BMI. Moreover, applying the PCA model to the replication sample yielded significant differences in cortical thickness between healthy controls and individuals with BD or schizophrenia. Cortical thickness in the same widespread regional network as determined by PCA was negatively associated with different clinical and demographic variables, including diagnosis, age, BMI, and treatment with antipsychotic medications or lithium. PCA outperformed clustering and provided an easy-to-use and interpret method to study multivariate associations between brain structure and system-level variables. PRACTITIONER POINTS: In this study of 2770 Individuals, we confirmed that cortical thickness in widespread regional networks as determined by principal component analysis (PCA) was negatively associated with relevant clinical and demographic variables, including diagnosis, age, BMI, and treatment with antipsychotic medications or lithium. Significant associations of many different system-level variables with the same brain network suggest a lack of one-to-one mapping of individual clinical and demographic factors to specific patterns of brain changes. PCA outperformed clustering analysis in the same data set when predicting group or BMI, providing a superior method for studying multivariate associations between brain structure and system-level variables.
- MeSH
- analýza hlavních komponent * MeSH
- bipolární porucha * diagnostické zobrazování farmakoterapie patologie MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční tomografie * metody MeSH
- mladý dospělý MeSH
- mozek diagnostické zobrazování patologie MeSH
- mozková kůra diagnostické zobrazování patologie MeSH
- obezita * diagnostické zobrazování MeSH
- schizofrenie diagnostické zobrazování patologie farmakoterapie patofyziologie MeSH
- shluková analýza MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Lateral ventricular enlargement represents a canonical morphometric finding in chronic patients with schizophrenia; however, longitudinal studies elucidating complex dynamic trajectories of ventricular volume change during critical early disease stages are sparse. METHODS: We measured lateral ventricular volumes in 113 first-episode schizophrenia patients (FES) at baseline visit (11.7 months after illness onset, SD = 12.3) and 128 age- and sex-matched healthy controls (HC) using 3T MRI. MRI was then repeated in both FES and HC one year later. RESULTS: Compared to controls, ventricular enlargement was identified in 18.6% of patients with FES (14.1% annual ventricular volume (VV) increase; 95%CI: 5.4; 33.1). The ventricular expansion correlated with the severity of PANSS-negative symptoms at one-year follow-up (p = 0.0078). Nevertheless, 16.8% of FES showed an opposite pattern of statistically significant ventricular shrinkage during ≈ one-year follow-up (-9.5% annual VV decrease; 95%CI: -23.7; -2.4). There were no differences in sex, illness duration, age of onset, duration of untreated psychosis, body mass index, the incidence of Schneiderian symptoms, or cumulative antipsychotic dose among the patient groups exhibiting ventricular enlargement, shrinkage, or no change in VV. CONCLUSION: Both enlargement and ventricular shrinkage are equally present in the early stages of schizophrenia. The newly discovered early reduction of VV in a subgroup of patients emphasizes the need for further research to understand its mechanisms.
- MeSH
- dospělí MeSH
- lidé MeSH
- longitudinální studie MeSH
- magnetická rezonanční tomografie * MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mozkové komory diagnostické zobrazování patologie MeSH
- progrese nemoci MeSH
- schizofrenie * diagnostické zobrazování patologie patofyziologie MeSH
- studie případů a kontrol MeSH
- ventriculi laterales diagnostické zobrazování patologie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Schizophrenia is a prototypical network disorder with widespread brain-morphological alterations, yet it remains unclear whether these distributed alterations robustly reflect the underlying network layout. We tested whether large-scale structural alterations in schizophrenia relate to normative structural and functional connectome architecture, and systematically evaluated robustness and generalizability of these network-level alterations. Leveraging anatomical MRI scans from 2439 adults with schizophrenia and 2867 healthy controls from 26 ENIGMA sites and normative data from the Human Connectome Project (n = 207), we evaluated structural alterations of schizophrenia against two network susceptibility models: (i) hub vulnerability, which examines associations between regional network centrality and magnitude of disease-related alterations; (ii) epicenter mapping, which identifies regions whose typical connectivity profile most closely resembles the disease-related morphological alterations. To assess generalizability and specificity, we contextualized the influence of site, disease stages, and individual clinical factors and compared network associations of schizophrenia with that found in affective disorders. Our findings show schizophrenia-related cortical thinning is spatially associated with functional and structural hubs, suggesting that highly interconnected regions are more vulnerable to morphological alterations. Predominantly temporo-paralimbic and frontal regions emerged as epicenters with connectivity profiles linked to schizophrenia's alteration patterns. Findings were robust across sites, disease stages, and related to individual symptoms. Moreover, transdiagnostic comparisons revealed overlapping epicenters in schizophrenia and bipolar, but not major depressive disorder, suggestive of a pathophysiological continuity within the schizophrenia-bipolar-spectrum. In sum, cortical alterations over the course of schizophrenia robustly follow brain network architecture, emphasizing marked hub susceptibility and temporo-frontal epicenters at both the level of the group and the individual. Subtle variations of epicenters across disease stages suggest interacting pathological processes, while associations with patient-specific symptoms support additional inter-individual variability of hub vulnerability and epicenters in schizophrenia. Our work outlines potential pathways to better understand macroscale structural alterations, and inter- individual variability in schizophrenia.
- MeSH
- dospělí MeSH
- konektom * metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční tomografie * metody MeSH
- mladý dospělý MeSH
- mozek patologie patofyziologie MeSH
- mozková kůra patologie patofyziologie MeSH
- nervová síť patologie patofyziologie diagnostické zobrazování MeSH
- nervové dráhy patofyziologie patologie MeSH
- schizofrenie * patologie patofyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- endofenotypy MeSH
- kognitivní dysfunkce etiologie patofyziologie patologie MeSH
- lidé MeSH
- psychosociální intervence metody MeSH
- schizofrenie * diagnóza patofyziologie patologie terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
- MeSH
- exekutivní funkce MeSH
- kognitivní remediace * metody MeSH
- lidé MeSH
- schizofrenie * patologie rehabilitace terapie MeSH
- software MeSH
- učení MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
- MeSH
- kognitivní dysfunkce * etiologie psychologie MeSH
- lidé MeSH
- schizofrenie * patologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- kazuistiky MeSH
Cíl práce: Prokázat u nemocných po první epizodě schizofrenie strukturální změny bílé hmoty mozkové pomod fixel-based analýzy (FBA). Metodika: V prospektivnf studii byly pomod FBA studovány difuzně vážené MR obrazy skupiny pacientů po první epizodě schizofrenie (n = 16) a kontrolní skupiny (n = 22). Vyšetření proběhlo na 3T MR tomografu s využitím 64-kanálové hlavové dvky. FBA byla provedena pomocí softwarového balíku MRtrix (verze 3.0.1). Výsledky: Pomod FBA byl u nemocných prokázán pokles metriky fibre density v oblasti commissura anterior. Nebyly nalezeny statisticky významné oblasti se změnami metriky fibre cross-section. Pro kombinovanou metriku fibre density and cross-section byl nalezen jeden statisticky významný fixel v bílé hmotě frontální části pravostranného centrum semiovale. Závěr: Pomocí FBA byl prokázán u nemocných po první epizodě schizofrenie při srovnání s kontrolním souborem velmi malý rozsah změn v bílé hmotě mozkové. Jejich charakter svědd pro poruchu mikrostruktury bílé hmoty u nemocných. Maximum prokázaných změn leží v commissura anterior. Rozsah nalezených změn je při porovnání s publikovanými pracemi využívajícími FBA výrazně menší, což může být podmíněno mj. časnějším stadiem onemocnění probandů ve vyšetřovaném souboru.
Purpose: To assess white matter changes after the first episode of schizophrenia by using fixel-based analysis (FBA). Methods: Diffusion weighted MR images were used to prospectively compare white matter microstructure between subjects after the first episode of schizophrenia (n = 16) and healthy controls (n = 22). The subjects were examined on a 3 Tesla MRI system equipped with a 64-channel head coil. FBA was performed using MRtrix software package (version 3.0.1). Results: A limited area of fibre density decrease was found in the anterior commissure. No fixels of fibre cross-sedion changes were found. For combined metric of fibre density and cross-sedion only one statistically significant fixel was found in the right frontal white matter. Conclusion: Using FBA, only a limited area of white matter microstructure corruption was found after the first episode of schizophrenia. Changes were located mainly in the anterior commissure. Compared to other published studies using FBA, the extent of changes is distinctly smaller which can be among other causes subjected to earlier stages of the illness of subjects included in this study.
- Klíčová slova
- fixel-based analýza,
- MeSH
- bílá hmota diagnostické zobrazování patologie MeSH
- commissura anterior diagnostické zobrazování patologie MeSH
- lidé MeSH
- magnetická rezonanční tomografie * metody MeSH
- prospektivní studie MeSH
- schizofrenie * diagnostické zobrazování patologie MeSH
- zobrazování difuzních tenzorů metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
