Schneider Frank, Habel Ute, Reske Martina, Kellermann Thilo, Stöcker Tony, Shah N Jon, Zilles Karl, Braus Dieter F, Schmitt Andrea, Schlösser Ralf, Wagner Michael, Frommann Ingo, Kircher Tilo, Rapp Alexander, Meisenzahl Eva, Ufer Sandra, Ruhrmann Stephan, Thienel Renate, Sauer Heinrich, Henn Fritz A, Gaebel Wolfgang
Department of Psychiatry and Psychotherapy, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany.
Schizophr Res. 2007 Jan;89(1-3):198-210. doi: 10.1016/j.schres.2006.07.021. Epub 2006 Sep 28.
Working memory dysfunction is a prominent impairment in patients with schizophrenia. Our aim was to determine cerebral dysfunctions by means of functional magnetic resonance imaging (fMRI) in a large sample of first-episode schizophrenia patients during a working memory task. 75 first-episode schizophrenia patients and 81 control subjects, recruited within a multi-center study, performed 2- and 0-back tasks while brain activation was measured with fMRI. In order to guarantee comparability between data quality from different scanners, we developed and adopted a standardized, fully automated quality assurance of scanner hard- and software as well as a measure for in vivo data quality. After these quality-control measures had been implemented, 48 patients and 57 controls were included in the final analysis. During attention-related processes, even when the performance between patients and controls was comparable, there was a recognizable emergence of cerebral dysfunctions with hypoactivations in the ventrolateral prefrontal cortex (VLPFC), in the superior temporal cortex and in the thalamus. During working memory performance, parietal hypoactivations, especially in the precuneus, were prominent and were accompanied by poorer performance in patients. A hyperfrontality emerged in the ventrolateral prefrontal cortex. Hence, results point to a dysfunctional ventrolateral prefrontal-parietal network during working memory in patients, suggesting impairments in basic functions such as retrieval, storage and maintenance. The brain activation pattern of this large and significant sample of first-episode schizophrenia patients indicates an imbalanced system failing to adjust the amount of brain activity required in the cerebral network involved in attention and working memory.
工作记忆功能障碍是精神分裂症患者的一项突出损害。我们的目的是通过功能磁共振成像（fMRI），在一大群首发精神分裂症患者执行工作记忆任务期间确定大脑功能障碍情况。在一项多中心研究中招募的75名首发精神分裂症患者和81名对照受试者，在执行2-back和0-back任务时，通过fMRI测量大脑激活情况。为确保不同扫描仪的数据质量具有可比性，我们开发并采用了一种标准化、全自动的扫描仪硬件和软件质量保证方法以及一种体内数据质量测量方法。在实施这些质量控制措施后，最终分析纳入了48名患者和57名对照。在与注意力相关的过程中，即使患者和对照之间的表现具有可比性，在腹外侧前额叶皮层（VLPFC）、颞上叶皮层和丘脑出现了可识别的大脑功能障碍，表现为激活不足。在工作记忆执行过程中，顶叶激活不足，尤其是楔前叶，非常明显，并且患者的表现较差。腹外侧前额叶皮层出现了额叶过度激活。因此，结果表明患者在工作记忆期间腹外侧前额叶-顶叶网络功能失调，提示在诸如检索、存储和维持等基本功能方面存在损害。这个大规模且具有显著意义的首发精神分裂症患者样本的大脑激活模式表明，该系统失衡，无法调整参与注意力和工作记忆的大脑网络所需的大脑活动量。
