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首发未经治疗的精神分裂症患者的异常固有大脑活动和认知缺陷。

Aberrant intrinsic brain activity and cognitive deficit in first-episode treatment-naive patients with schizophrenia.

机构信息

The Mental Health Center and the Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

出版信息

Psychol Med. 2013 Apr;43(4):769-80. doi: 10.1017/S0033291712001638. Epub 2012 Aug 10.

Abstract

BACKGROUND

Given the important role of the default mode network (DMN) in cognitive function and the well-known neurocognitive deficit in schizophrenia, it is intriguing to examine systematically the relationship between neurocognitive dysfunction and aberrant intrinsic activities, and also functional connectivity, of the DMN in patients with schizophrenia. Method First-episode, treatment-naive patients with schizophrenia (FES) (n = 115) and healthy controls (n = 113) underwent resting-state functional magnetic resonance imaging (fMRI) scans and neurocognitive tests. Intrinsic neural activities evaluated by using the fragment amplitude of low-frequency fluctuations (fALFF) and the resting-state functional connectivity assessed by seed-based correlational analysis were compared between patients and controls. Aberrant intrinsic activities and DMN connectivity in patients were then correlated to neurocognitive performance and clinical symptoms.

RESULTS

Compared to controls, patients with FES showed decreased fALFF in the bilateral medial prefrontal cortex (MPFC) and the orbitofrontal cortex (OFC), and increased fALFF in the bilateral putamen. Increased functional connectivity with the DMN was observed in the left insula and bilateral dorsolateral PFC (DLPFC) in patients with FES. In patients, aberrant fALFF in the bilateral OFC were correlated with cognitive processing speed; fALFF in the left OFC and right putamen were correlated with the clinical factors excited/activation and disorganization; and increased DMN functional connectivity in the left insula was correlated with the clinical factors positive, excited/activation, disorganization and neurocognitive deficit in the domain of sustained attention.

CONCLUSIONS

These associations between neurocognitive dysfunction and aberrant intrinsic activities, and also functional connectivity, of the DMN in patients with schizophrenia may provide important insights into the neural mechanism of the disease.

摘要

背景

鉴于默认模式网络(DMN)在认知功能中的重要作用,以及精神分裂症中众所周知的神经认知缺陷,系统地研究精神分裂症患者的神经认知功能障碍与 DMN 的内在活动异常和功能连接之间的关系是很有趣的。方法:首先,对未经治疗的首发精神分裂症患者(FES)(n = 115)和健康对照组(n = 113)进行静息态功能磁共振成像(fMRI)扫描和神经认知测试。通过低频波动幅度片段(fALFF)评估内在神经活动,并通过基于种子的相关分析评估静息状态功能连接,比较患者和对照组之间的差异。然后,将患者的异常内在活动和 DMN 连接与神经认知表现和临床症状相关联。结果:与对照组相比,FES 患者双侧内侧前额叶皮质(MPFC)和眶额皮质(OFC)的 fALFF 降低,双侧壳核的 fALFF 增加。FES 患者左岛叶和双侧背外侧前额叶皮质(DLPFC)的 DMN 功能连接增加。在患者中,双侧 OFC 的异常 fALFF 与认知加工速度相关;左 OFC 和右壳核的 fALFF 与兴奋/激活和紊乱的临床因素相关;左岛叶的 DMN 功能连接增加与阳性、兴奋/激活、紊乱和持续注意力领域的神经认知缺陷的临床因素相关。结论:这些精神分裂症患者的神经认知功能障碍与 DMN 的异常内在活动和功能连接之间的关联,可能为该疾病的神经机制提供重要的见解。

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