在精神分裂症和双相情感障碍中治疗反应的神经发育预测因素
Anton Iftimovici1,2,3,4, Emma Krebs1, William Dalfin1
1Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Paris, France.
Psychological medicine
|October 15, 2024
概括
神经发育标志物,如神经软征兆 (NSS) 和早期临床发病,可以预测精神分裂症和双相情感障碍的治疗抵抗性. 识别这些标志物有助于及时调整治疗以获得更好的患者结果.
科学领域:
- 精神病学和神经科学 精神病学和神经科学
- 临床心理学 临床心理学
- 发育神经科学的发展神经科学.
背景情况:
- 治疗耐药性是管理精神疾病的一个重要障碍.
- 早期识别潜在的治疗耐药性可以改善患者的预后和恢复时间表.
- 这项研究研究了神经发育标志物,用于预测治疗反应.
研究的目的:
- 确定神经发育标志物是否可以预测精神分裂症和双相情感障碍患者的治疗耐药性.
- 确定与治疗结果相关的特定早期发育异常和神经软征兆 (NSS).
- 评估这些标记在将患者分类为治疗反应或耐药时的有用性.
主要方法:
- 对已知治疗结果的健康对照 (N=236) 和精神分裂症 (N=280) 或双极性障碍 (N=78) 患者的回顾性分析.
- 数据收集包括人口统计,早期发育异常,神经软征兆 (NSS) 和关键临床里程碑的年龄.
- 采用监督算法,使用NSS和精神分裂症患者最初临床症状的年龄来对治疗反应进行分类.
主要成果:
- 与对照人群相比,精神分裂症和双相情感障碍患者的发育异常更为普遍.
- 神经软征兆 (NSS) 在精神分裂症和双相情感障碍 (p < 1x10^-10) 中在对照组,响应组和耐药组显著不同.
- 在精神分裂症中,耐药患者表现出主观损伤和临床症状的早期发作,与响应的患者相比 (p < 1x10^-4和p < 1x10^-3). 第一次临床症状的年龄和NSS准确预测了精神分裂症的治疗反应 (AUC:77 ± 8%,p = 1x10^-14).
结论:
- 神经发育特征,特别是NSS和临床发病年龄,可以作为预测治疗反应的有价值指标.
- 这些发现表明,早期识别可能耐治疗的患者是可行的.
- 这可以促进迅速的治疗适应,可能导致改善临床结果.
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