精神分裂症超高危人群经颅磁刺激干预的磁共振研究

Individuals at Ultra-High-Risk for schizoprenia (UHR) refer to the crowd in schizophrenic prodromal period (known as ultra-high-risk period, defined as the period of time from the first change in a person until development of the first frank psychotic symptoms).The UHR has been attached to prodromal symptoms including decreased functions and behavioral changes, suspicion, and decreased attention so on. We have found in clinical practice that repetitive transcranial magnetic stimulation (rTMS) intervention can improve the symptoms and function in the UHR. Furthermore, our previous studies indicated that the decreased connectivity of inferior frontal white matter and reduction in middle temporal gray matter volume may be potential schizophrenic endophenotypes (intermediate phenotypes). So we presume that there might be some brain regions of structural and functional damage in the UHR before and after using the the rTMS intervention, and these brain damaged regions may the schizophrenia endophenotypes. In this study, we examine intervention group and pseudo-intervention group from the UHR,schizophrenic first-degree relatives, and healthy controls using a battery of cognitive assessment tools and magnetic resonance imaging (MRI) and the UHR is firstly intervened with low-frequency rTMS. The success of the present research will help us explore endophenotypes for schizophrenia on cognition, brain imaging and brain mechanisms about the rTMS intervention, and explore biological markers of schizophrenia, and provide theoretical support and practice of prodromal phase intervention.

精神分裂症超高危人群(UHR)是指处在精神分裂症前驱期（也称超高危期，是指从首次行为改变开始到首次精神病发作之前的阶段）状态人群，常出现功能下降和行为改变、猜疑、注意力下降等某些前驱期症状。申请者在临床实践中发现采用重复经颅磁刺激（rTMS)可以改善UHR的症状和功能，同时，我们前期研究发现额下白质连接性下降、颞中灰质体积减少可能是精神分裂症的潜在内表型(中间表型)。据此我们推测，UHR经rTMS干预前后都存在某些脑区结构和功能损害,这些损害可能是精神分裂症内表型，可以作为早期识别的生物学标记。 本研究拟首次采用rTMS对UHR进行干预，同时对rTMS干预组，UHR伪干预组、一级健康亲属及健康人群进行认知功能和脑影像学检查，以此来探讨精神分裂症认知功能及脑影像学相关内表型及其病理机制。本研究将有助于更好寻找精神分裂症的生物学标记，为早期干预提供理论支持和实践方法。

精神分裂症是精神科最常见的复杂性脑疾病，长期以来，学者们致力于寻找精神分裂症的生物学指标，如果在精神分裂症首次发病之前（高危期和前驱期）检测这类生物学标记，就可以进行早期识别和预警，并采取干预措施，来减少疾病发生率和严重性。精神分裂症超高危人群(UHR)是指处在精神分裂症前驱期（也称超高危期，是指从首次行为改变开始到首次精神病发作之前的阶段）状态人群，常出现功能下降和行为改变、猜疑、注意力下降等某些前驱期症状。采用重复经颅磁刺激（rTMS)可以改善UHR的症状和功能， 本研究拟采用rTMS对UHR进行干预，同时对rTMS干预组，UHR伪干预组、一级健康亲属及健康人群进行认知功能和脑影像学检查，我们研究发现信息处理和执行功能认知缺陷，和额下白质连接性下降、颞中灰质体积减少可能是精神分裂症的潜在内表型(中间表型)，本研究将有助于更好寻找精神分裂症的生物学标记，为早期干预提供理论支持和实践方法。