背景:精神分裂症被概念化为一种脑连接体障碍,可以在儿童晚期和青春期出现。然而,潜在的神经发育基础仍不清楚.最近对在关键大脑发育时期出现症状的儿童和青少年患者的兴趣越来越大。受到先进的方法论理论和大型患者队列的启发,中国研究人员在了解早发性精神分裂症(EOS)中改变的大脑连接体发育方面做出了重大的原创性贡献。
方法:我们对PubMed和WebofScience进行了一项关于精神分裂症和神经发育中脑连接体的研究。在这次选择性审查中,我们首先讨论大脑结构和功能发育的最新理论。随后,我们综合了有关EOS中脑结构和功能异常机制的中国研究结果。最后,我们强调了这一领域的几个关键挑战和问题。
结果:典型的神经发育遵循以灰质体积修剪为特征的轨迹,增强结构和功能连通性,提高结构连接体效率,以及儿童晚期和青春期功能连接体中的分化模块。相反,EOS随着灰质体积的过度下降而偏离,皮质变薄,降低了结构大脑网络中的信息处理效率,和功能大脑网络的成熟失调。此外,在早期和成年发病患者中发现了默认模式区域的常见功能连接体破坏。
结论:中国对EOS脑连接组的研究为理解病理机制提供了重要证据。进一步研究,利用基于大样本多中心数据集的标准化分析,有可能为早期干预和疾病治疗提供客观指标。
BACKGROUND: Schizophrenia is conceptualized as a brain connectome disorder that can emerge as early as late childhood and adolescence. However, the underlying neurodevelopmental basis remains unclear. Recent interest has grown in children and adolescent patients who experience symptom onset during critical brain development periods. Inspired by advanced methodological theories and large patient cohorts, Chinese researchers have made significant original contributions to understanding altered brain connectome development in early-onset schizophrenia (EOS).
METHODS: We conducted a search of PubMed and Web of Science for studies on brain connectomes in schizophrenia and neurodevelopment. In this selective review, we first address the latest theories of brain structural and functional development. Subsequently, we synthesize Chinese findings regarding mechanisms of brain structural and functional abnormalities in EOS. Finally, we highlight several pivotal challenges and issues in this field.
RESULTS: Typical neurodevelopment follows a trajectory characterized by gray matter volume pruning, enhanced structural and functional connectivity, improved structural connectome efficiency, and differentiated modules in the functional connectome during late childhood and adolescence. Conversely, EOS deviates with excessive gray matter volume decline, cortical thinning, reduced information processing efficiency in the structural brain network, and dysregulated maturation of the functional brain network. Additionally, common functional connectome disruptions of default mode regions were found in early- and adult-onset patients.
CONCLUSIONS: Chinese research on brain connectomes of EOS provides crucial evidence for understanding pathological mechanisms. Further studies, utilizing standardized analyses based on large-sample multicenter datasets, have the potential to offer objective markers for early intervention and disease treatment.