Benedetti Francesco, Bernasconi Alessandro, Bosia Marta, Cavallaro Roberto, Dallaspezia Sara, Falini Andrea, Poletti Sara, Radaelli Daniele, Riccaboni Roberta, Scotti Giuseppe, Smeraldi Enrico
Department of Clinical Neurosciences, Scientific Institute and University Vita-Salute San Raffaele, Milan, Italy.
Schizophr Res. 2009 Oct;114(1-3):154-60. doi: 10.1016/j.schres.2009.06.021. Epub 2009 Jul 26.
Patients affected by schizophrenia show deficits in social cognition, with abnormal performance on tasks targeting theory of mind (ToM) and empathy (Emp). Brain imaging studies suggested that ToM and Emp depend on the activation of brain networks mainly localized at the superior temporal lobe and temporo-parietal junction.
Participants included 24 schizophrenia patients and 20 control subjects. We used brain blood oxygen level dependent fMRI to study the neural responses to tasks targeting ToM and Emp. We then studied voxel-based morphometry of grey matter in areas where diagnosis influenced functional activation to both tasks. Outcomes were analyzed in the context of the general linear model, with global grey matter volume as nuisance covariate for structural MRI.
Patients showed worse performance on both tasks. We found significant effects of diagnosis on neural responses to the tasks in a wide cluster in right posterior superior temporal lobe (encompassing BA 22-42), in smaller clusters in left temporo-parietal junction and temporal pole (BA 38 and 39), and in a white matter region adjacent to medial prefrontal cortex (BA 10). A pattern of double dissociation of the effects of diagnosis and task on neural responses emerged. Among these areas, grey matter volume was found to be reduced in right superior temporal lobe regions of patients.
Functional and structural abnormalities were observed in areas affected by the schizophrenic process early in the illness course, and known to be crucial for social cognition, suggesting a biological basis for social cognition deficits in schizophrenia.
精神分裂症患者存在社会认知缺陷，在针对心理理论（ToM）和共情（Emp）的任务中表现异常。脑成像研究表明，ToM和Emp依赖于主要位于颞上叶和颞顶叶交界处的脑网络的激活。
参与者包括24名精神分裂症患者和20名对照受试者。我们使用基于脑血氧水平依赖的功能磁共振成像（fMRI）来研究对针对ToM和Emp任务的神经反应。然后，我们研究了在诊断对两项任务的功能激活有影响的区域中灰质的基于体素的形态学。在一般线性模型的背景下分析结果，将全脑灰质体积作为结构磁共振成像（MRI）的干扰协变量。
患者在两项任务上的表现均较差。我们发现，诊断对右侧颞上叶后部一个广泛簇（包括BA 22 - 42）、左侧颞顶叶交界处和颞极较小簇（BA 38和39）以及与内侧前额叶皮质相邻的白质区域（BA 10）中任务的神经反应有显著影响。出现了诊断和任务对神经反应影响的双重解离模式。在这些区域中，发现患者右侧颞上叶区域的灰质体积减少。
在疾病过程早期受精神分裂症影响且已知对社会认知至关重要的区域中观察到功能和结构异常，这表明精神分裂症社会认知缺陷存在生物学基础。
