Pattern Analysis of Volume of Basal Ganglia Structures in Patients with First-Episode Psychosis

초발 정신병 환자에서 기저핵 구조물 부피의 패턴분석

  • Min, Sally (Department of Medicine, Seoul National University College of Medicine) ;
  • Lee, Tae Young (Department of Psychiatry, Seoul National University College of Medicine) ;
  • Kwak, Yoobin (Department of Brain & Cognitive Sciences, Seoul National University College of Natural Science) ;
  • Kwon, Jun Soo (Department of Medicine, Seoul National University College of Medicine)
  • 민세리 (서울대학교 의과대학 의학과학교실) ;
  • 이태영 (서울대학교 의과대학 신경정신의학교실) ;
  • 곽유빈 (서울대학교 자연과학대학 뇌인지과학과) ;
  • 권준수 (서울대학교 의과대학 의학과학교실)
  • Received : 2018.03.13
  • Accepted : 2018.05.09
  • Published : 2018.05.31


Objectives Dopamine dysregulation has been regarded as one of the core pathologies in patients with schizophrenia. Since dopamine synthesis capacity has found to be inconsistent in patients with schizophrenia, current classification of patients based on clinical symptoms cannot reflect the neurochemical heterogeneity of the disease. Here we performed new subtyping of patients with first-episode psychosis (FEP) through biotype-based cluster analysis. We specifically suggested basal ganglia structural changes as a biotype, which deeply involves in the dopaminergic circuit. Methods Forty FEP and 40 demographically matched healthy participants underwent 3T T1 MRI. Whole brain parcellation was conducted, and volumes of total 6 regions of basal ganglia have been extracted as features for cluster analysis. We used K-means clustering, and external validation was conducted with Positive and Negative Syndrome Scale (PANSS). Results K-means clustering divided 40 FEP subjects into 2 clusters. Cluster 1 (n = 25) showed substantial volume decrease in 4 regions of basal ganglia compared to Cluster 2 (n = 15). Cluster 1 showed higher positive scales of PANSS compared with Cluster 2 (F = 2.333, p = 0.025). Compared to healthy controls, Cluster 1 showed smaller volumes in 4 regions, whereas Cluster 2 showed larger volumes in 3 regions. Conclusions Two subgroups have been found by cluster analysis, which showed a distinct difference in volume patterns of basal ganglia structures and positive symptom severity. The result possibly reflects the neurobiological heterogeneity of schizophrenia. Thus, the current study supports the importance of paradigm shift toward biotype-based diagnosis, instead of phenotype, for future precision psychiatry.


Supported by : 한국연구재단


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