Neuronale Korrelate des Psychoserisikosyndroms

D. Hirjak; P. A. Thomann; M. S. Depping; R. C. Wolf

doi:10.1055/s-0038-1628530

Nervenheilkunde, Inhaltsverzeichnis

Nervenheilkunde 2013; 32(08): 582-591
DOI: 10.1055/s-0038-1628530

Übersichtsartikel

Schattauer GmbH

Neuronale Korrelate des Psychoserisikosyndroms

Strukturelles Neuroimaging bei Personen mit erhöhtem PsychoserisikoStructural neuroimaging markers in individuals with ultra-high risk conditions for developing psychosis

D. Hirjak

¹Zentrum für Psychosoziale Medizin, Klinik für Allgemeine Psychiatrie, Universitätsklinik Heidelberg

,

P. A. Thomann

¹Zentrum für Psychosoziale Medizin, Klinik für Allgemeine Psychiatrie, Universitätsklinik Heidelberg

,

M. S. Depping

¹Zentrum für Psychosoziale Medizin, Klinik für Allgemeine Psychiatrie, Universitätsklinik Heidelberg

,

R. C. Wolf

¹Zentrum für Psychosoziale Medizin, Klinik für Allgemeine Psychiatrie, Universitätsklinik Heidelberg

› Institutsangaben

Abstract

Zusammenfassung

Das erhöhte Psychoserisiko ist durch klinischpsychopathologische Merkmale definiert. Eine objektive Erfassung von Personen mit Hochrisikosymptomen und deren klinische Konversion in die manifeste Störung anhand Hirnbildgebungsmarkern könnte durch frühzeitige Interventionen die Prognose der manifesten Erkrankung positiv beeinflussen und die Einleitung störungsorientierter und individualisierter Therapien erleichtern. Trotz einer zunehmenden Anzahl neurobiologischer Studien bei Hochrisikopersonen (HRP) sind die neuronalen Korrelate des erhöhten Psychoserisikos unklar. In dieser Übersichtsarbeit soll die strukturell bildgebende Datenlage bei Personen mit erhöhtem Psychoserisiko vorgestellt und diskutiert werden. In der Literatur konnten anhand einer systematischen Literatursuche via PubMed und MEDLINE (Schlüsselwörter: “psychosis”, “ultra-high-risk”, “dti” und “mri”) und einer erweiterten Literaturrecherche elf strukturelle Bildgebungsstudien, zwei Übersichtsarbeiten und zwei Metaanalysen identifiziert werden. In der Gesamtwertung der Daten gibt es erste Hinweise darauf, dass bei Personen mit erhöhtem Psychoserisiko neuroanatomisch umschriebene Veränderungen der Gehirnstruktur vorliegen könnten. Der prädiktive Wert dieser Befunde im Hinblick auf einer Konversion in die manifeste Psychose kann noch nicht abschließend gewertet werden.

Summary

At present, ultra-high risk (UHR) conditions for developing psychosis are clinically defined syndromes. Early recognition of UHR individuals together with monitoring their transition to full-blown psychosis by means of neuroimaging markers may positively influence recognition, may provide an additional means for guiding early and effective interventions and thus eventually improving clinical outcome parameters. The aim of this article was to systematically review structural neuroimaging findings in individuals meeting UHR criteria. A criteria-based literature search was performed using the electronic databases PubMed and MEDLINE using the keywords “psychosis”, “prodrome OR high risk”, “mri” and “dti”. Relevant literature between January 1977 and August 2012 was considered. We identified eleven whole-brain MRI studies, two reviews and two meta-analyses. Considering the extant data, there is some evidence for grey and white matter alterations within several brain regions which have been associated with manifest psychosis in previous studies conducted in patients with psychotic disorders. However, based on the extant evidence it is currently premature to fully appreciate the clinical significance of brain structural findings in UHR-individuals.

Schlüsselwörter

Psychoserisikosyndrom - MRT - UHR-Kriterien - Psychose - strukturelle Bildgebung

Keywords

Clinical at-risk mental state - MRI - UHR criteria - psychosis - structural neuroimaging

Volltext

Referenzen

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