Kuperberg Gina R, West W Caroline, Lakshmanan Balaji M, Goff Don
MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts 02129, USA.
Biol Psychiatry. 2008 Sep 1;64(5):407-18. doi: 10.1016/j.biopsych.2008.03.018. Epub 2008 May 27.
Schizophrenia symptoms can be conceptualized in terms of a breakdown of a balance between 1) activating, retrieving, and matching stored representations to incoming information (semantic memory-based processing) and 2) fully integrating activated semantic representations with one another and with other types of representations to form a gestalt representation of meaning (semantic integration). Semantic memory-based processes are relatively more dependent on inferior frontal and temporal cortices, whereas particularly demanding integrative processes additionally recruit the dorsolateral prefrontal cortex (DLPFC) and sometimes parietal cortices. We used functional magnetic resonance imaging (fMRI) to determine whether the modulation of temporal/inferior frontal cortices and the DLPFC can be neuroanatomically dissociated in schizophrenia, as semantic integration demands increase. Integration demands were manipulated by varying the nature (concrete vs. abstract) and the congruity (incongruous vs. congruous) of words within sentences.
Sixteen right-handed schizophrenia patients and 16 healthy volunteers, matched on age and parental socioeconomic status, underwent event-related fMRI scanning while they read sentences. Blood oxygen level dependent (BOLD) effects were contrasted to words within sentences that were 1) concrete versus abstract and 2) semantically incongruous versus congruous with their preceding contexts.
In both contrasts, large networks mediating the activation and retrieval of verbal and imagistic representations were normally modulated in patients. However, unlike control subjects, patients failed to recruit the DLPFC, medial frontal and parietal cortices to incongruous (relative to congruous) sentences, and failed to recruit the DLPFC to concrete (relative to abstract) sentences.
As meaning is built from language, schizophrenia patients demonstrate a neuroanatomical dissociation in the modulation of temporal/inferior frontal cortices and the DLPFC.
精神分裂症症状可以从以下两种平衡的破坏来理解:1)激活、检索存储的表征并将其与传入信息进行匹配(基于语义记忆的加工),以及2)将激活的语义表征彼此之间以及与其他类型的表征充分整合,以形成意义的整体表征(语义整合)。基于语义记忆的过程相对更依赖于额下回和颞叶皮质,而特别需要整合的过程还会额外激活背外侧前额叶皮质(DLPFC),有时还会激活顶叶皮质。随着语义整合需求的增加,我们使用功能磁共振成像(fMRI)来确定在精神分裂症中,颞叶/额下回皮质和DLPFC的调节是否在神经解剖学上存在分离。通过改变句子中单词的性质(具体与抽象)和一致性(不一致与一致)来操纵整合需求。
16名右利手精神分裂症患者和16名年龄及父母社会经济地位相匹配的健康志愿者在阅读句子时接受事件相关fMRI扫描。将血氧水平依赖(BOLD)效应与句子中的单词进行对比,这些单词在以下方面存在差异:1)具体与抽象,以及2)与其前文语境在语义上不一致与一致。
在这两种对比中,介导言语和意象表征的激活和检索的大型网络在患者中通常受到调节。然而,与对照组不同,患者在阅读不一致(相对于一致)的句子时未能激活DLPFC、内侧前额叶和顶叶皮质,在阅读具体(相对于抽象)的句子时也未能激活DLPFC。
随着意义从语言中构建起来,精神分裂症患者在颞叶/额下回皮质和DLPFC的调节上表现出神经解剖学上的分离。