Pathologie insulaire chez les jeunes avec un diagnostic d'autisme avec un haut fonctionnement cognitif et premier épisode psychotique

Aperçu: G.M.

Les troubles du spectre de l'autisme (TSA) et la psychose partagent des déficits de la cognition sociale. La région insulaire a été associée à la conscience de soi et de la réalité, ce qui peut être fondamental pour des interactions sociales appropriées.

Le volume et l'épaisseur réduits partagés dans les régions antérieure et postérieure de l'insula dans TSA et FEP (premier épisode psychotique) fournissent la première preuve provisoire que ces conditions partagent une pathologie structurelle qui peut être liée à une symptomatologie partagée. 

Psychol Med. 2017 Apr 24:1-11. doi: 10.1017/S0033291717000988.

Insular pathology in young people with high-functioning autism and first-episode psychosis

Parellada M¹, Pina-Camacho L¹, Moreno C¹, Aleman Y², Krebs MO³, Desco M², Merchán-Naranjo J¹, Del Rey-Mejías A¹, Boada L¹, Llorente C¹, Moreno D¹, Arango C¹, Janssen J¹.

Author information

1

Child and Adolescent Psychiatry Department,Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense,IiSGM, CIBERSAM. Ibiza 43,28009 Madrid,Spain.

2

Department of Experimental Medicine,Hospital General Universitario Gregorio Marañón,IiSGM, CIBERSAM,Ibiza 43, 28009 Madrid,Spain.

3

INSERM, U894, "Psychophysiology of psychiatric disorders Lab," Center for psychiatry and neurosciences, University Paris Descartes, Sorbonne Paris Cité; Institut de Psychiatrie-GDR 3557; and Service Hospitalo-Universitaire, Centre Hospitalier Sainte-Anne,Paris,France.

Abstract

BACKGROUND:

Autism Spectrum Disorders (ASD) and psychosis share deficits in social cognition. The insular region has been associated with awareness of self and reality, which may be basic for proper social interactions.

METHODS:

Total and regional insular volume and thickness measurements were obtained from a sample of 30 children and adolescents with ASD, 29 with early onset first-episode psychosis (FEP), and 26 healthy controls (HC). Total, regional, and voxel-level volume and thickness measurements were compared between groups (with correction for multiple comparisons), and the relationship between these measurements and symptom severity was explored.

RESULTS:

Compared with HC, a shared volume deficit was observed for the right (but not the left) anterior insula (ASD: p = 0.007, FEP: p = 0.032), and for the bilateral posterior insula: (left, ASD: p = 0.011, FEP: p = 0.033; right, ASD: p = 0.004, FEP: p = 0.028). A voxel-based morphometry (VBM) conjunction analysis showed that ASD and FEP patients shared a gray matter volume and thickness deficit in the left posterior insula. Within patients, right anterior (r = -0.28, p = 0.041) and left posterior (r = -0.29, p = 0.030) insular volumes negatively correlated with the severity of insight deficits, and left posterior insular volume negatively correlated with the severity of 'autistic-like' symptoms (r = -0.30, p = 0.028).

CONCLUSIONS:

The shared reduced volume and thickness in the anterior and posterior regions of the insula in ASD and FEP provides the first tentative evidence that these conditions share structural pathology that may be linked to shared symptomatology.

PMID: 28436341

DOI: 10.1017/S0033291717000988