Argyelan Miklos, Ikuta Toshikazu, DeRosse Pamela, Braga Raphael J, Burdick Katherine E, John Majnu, Kingsley Peter B, Malhotra Anil K, Szeszko Philip R
*To whom correspondence should be addressed; Psychiatry Research, Zucker Hillside Hospital, North Shore-LIJ Health System, 75-59 263rd Street, Glen Oaks, NY 11004, US; tel: 718-470-4486, fax: 718-343-1659, e-mail:
Schizophr Bull. 2014 Jan;40(1):100-10. doi: 10.1093/schbul/sbt092. Epub 2013 Jul 12.
Schizophrenia and bipolar disorder share aspects of phenomenology and neurobiology and thus may represent a continuum of disease. Few studies have compared connectivity across the brain in these disorders or investigated their functional correlates.
We used resting-state functional magnetic resonance imaging to evaluate global and regional connectivity in 32 healthy controls, 19 patients with bipolar disorder, and 18 schizophrenia patients. Patients also received comprehensive neuropsychological and clinical assessments. We computed correlation matrices among 266 regions of interest within the brain, with the primary dependent measure being overall global connectivity strength of each region with every other region.
Patients with schizophrenia had significantly lower global connectivity compared with healthy controls, whereas patients with bipolar disorder had global connectivity intermediate to and significantly different from those of patients with schizophrenia and healthy controls. Post hoc analyses revealed that compared with healthy controls, both patient groups had significantly lower connectivity in the paracingulate gyrus and right thalamus. Patients with schizophrenia also had significantly lower connectivity in the temporal occipital fusiform cortex, left caudate nucleus, and left thalamus compared with healthy controls. There were no significant differences among the patient groups in any of these regions. Lower global connectivity among all patients was associated with worse neuropsychological and clinical functioning, but these effects were not specific to any patient group.
These findings are consistent with the hypothesis that schizophrenia and bipolar disorder may represent a continuum of global disconnectivity in the brain but that regional functional specificity may not be evident.
精神分裂症和双相情感障碍在现象学和神经生物学方面存在共性，因此可能代表着一种疾病连续体。很少有研究比较过这些疾病患者大脑的全脑连接性，或探究其功能相关性。
我们使用静息态功能磁共振成像来评估32名健康对照者、19名双相情感障碍患者和18名精神分裂症患者的全脑和局部连接性。患者还接受了全面的神经心理学和临床评估。我们计算了大脑内266个感兴趣区域之间的相关矩阵，主要的因变量是每个区域与其他所有区域的整体全脑连接强度。
与健康对照者相比，精神分裂症患者的全脑连接性显著更低，而双相情感障碍患者的全脑连接性处于精神分裂症患者和健康对照者之间，且与二者均有显著差异。事后分析显示，与健康对照者相比，两组患者在扣带旁回和右侧丘脑的连接性均显著更低。与健康对照者相比，精神分裂症患者在颞枕梭状回、左侧尾状核和左侧丘脑的连接性也显著更低。在这些区域中，患者组之间没有显著差异。所有患者较低的全脑连接性与较差的神经心理学和临床功能相关，但这些影响并非特定于任何患者组。
这些发现与以下假设一致，即精神分裂症和双相情感障碍可能代表着大脑整体连接中断的一种连续体，但区域功能特异性可能并不明显。
