Background. Earlier studies examining structural brain abnormalities associated with cognitively derived subgroups were mainly cross-sectional in design and had mixed findings. Thus, we obtained cross-sectional and longitudinal data to characterize the extent and trajectory of brain structure abnormalities underlying distinct cognitive subtypes (“preserved,” “deteriorated,” and “compromised”) seen in psychotic spectrum disorders. Methods. Data from 364 subjects (225 patients with psychotic conditions and 139 healthy controls) were first used to determine the relationship of cognitive subtypes with cross-sectional measures of subcortical volume and cortical thickness. To probe neurodevelopmental abnormalities, brain structure laterality was examined. To examine whether neuroprogressive abnormalities persist, longitudinal brain structural changes over 5 years were examined within a subset of 101 subjects. Subsequent discriminant analysis using the identified brain measures was performed on an independent subject group. Results. Cross-sectional comparisons showed that cortical thinning and limbic volume reductions were most widespread in “deteriorated” cognitive subtype. Laterality comparisons showed more rightward amygdala lateralization in “compromised” than “preserved” subtype. Longitudinal comparisons revealed progressive hippocampal shrinkage in “deteriorated” compared with healthy controls and “preserved” subtype, which correlated with worse negative symptoms, cognitive and psychosocial functioning. Post-hoc discrimination analysis on an independent group of 52 subjects using the identified brain structures found an overall accuracy of 71% for classification of cognitive subtypes. Conclusion. These findings point toward distinct extent and trajectory of corticolimbic abnormalities associated with cognitive subtypes in psychosis, which can allow further understanding of the biological course of cognitive functioning over illness course and with treatment.

中文翻译：

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皮质边缘脑异常与精神病的认知亚型有关：一项纵向研究

背景。早期研究与认知衍生亚组相关的结构性大脑异常的研究主要是横断面设计，结果喜忧参半。因此，我们获得了横断面和纵向数据，以表征精神病谱系障碍中不同认知亚型（“保留”、“恶化”和“受损”）背后的大脑结构异常的程度和轨迹。方法。来自 364 名受试者（225 名精神病患者和 139 名健康对照者）的数据首先被用于确定认知亚型与皮质下体积和皮质厚度的横截面测量值之间的关系。为了探测神经发育异常，检查了大脑结构的偏侧性。为了检查神经进行性异常是否持续存在，在 101 名受试者的子集中检查了超过 5 年的纵向大脑结构变化。使用确定的大脑测量值对独立的受试者组进行后续判别分析。结果。横断面比较显示皮质变薄和边缘体积减少在“恶化”认知亚型中最为普遍。侧向性比较显示“受损”亚型比“保留”亚型更向右杏仁核侧化。纵向比较显示，与健康对照和“保留”亚型相比，“恶化”的海马逐渐萎缩，这与更严重的阴性症状、认知和心理社会功能相关。使用已识别的大脑结构对 52 名受试者的独立组进行事后歧视分析，发现认知亚型分类的总体准确率为 71%。结论。这些发现指出了与精神病认知亚型相关的皮质边缘异常的不同程度和轨迹，这可以让我们进一步了解疾病过程和治疗过程中认知功能的生物学过程。