Abstract:
The risk for developing schizophrenia is increased among first-degree relatives of those with psychotic disorders, but the risk is even higher in those meeting established criteria for clinical high risk (CHR), a clinical construct most often comprising of attenuated psychotic experiences. Conversion to psychosis among CHR youth has been reported to be about 15-35% over three years. Accurately identifying individuals whose psychotic symptoms will worsen would facilitate earlier intervention, but this has been difficult to do using behavior measures alone. Brain-based risk markers have the potential to improve the accuracy of predicting outcomes in CHR youth. This narrative review provides an overview of neuroimaging studies used to investigate psychosis risk, including studies involving structural, functional, and diffusion imaging, functional connectivity, positron emission tomography, arterial spin labeling, magnetic resonance spectroscopy, and multi-modality approaches. We present findings separately in those observed in the CHR state and those associated with psychosis progression or resilience. Finally, we discuss future research directions that could improve clinical care for those at high risk for developing psychotic disorders.
摘要:
精神病患者的一级亲属患精神分裂症的风险增加,但在符合既定临床高风险(CHR)标准的人群中,风险甚至更高,一种临床结构,最常包括减弱的精神病经历。据报道,三年内CHR青年的精神病转化率约为15-35%。准确识别精神病症状会恶化的个体将有助于早期干预,但这很难单独使用行为措施。基于大脑的风险标志物有可能提高CHR青年预测结果的准确性。这篇叙述性综述概述了用于调查精神病风险的神经影像学研究,包括涉及结构的研究,功能,和扩散成像,功能连接,正电子发射断层扫描,动脉自旋标记,磁共振波谱,和多模态方法。我们分别介绍了在CHR状态下观察到的发现以及与精神病进展或韧性相关的发现。最后,我们讨论了未来的研究方向,这些研究方向可以改善精神病高危人群的临床护理。