Zhang Fangfang, Qiu Linlin, Yuan Lili, Ma Huijuan, Ye Rong, Yu Fengqiong, Hu Panpan, Dong Yi, Wang Kai
Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, PR China.
Department of Medical Psychology, Anhui Medical University, Hefei, Anhui Province, PR China.
Schizophr Res. 2014 Oct;159(1):31-5. doi: 10.1016/j.schres.2014.07.050. Epub 2014 Aug 28.
It has long been debated whether a progressive process is involved in schizophrenia. The aim of the current study was to determine whether a progressive process was involved in patients with early schizophrenia, who were drug naive or had received short-term minimal antipsychotic treatment to avoid the distortion through medication effects. Twenty-eight patients with schizophrenia with illness-duration of up to 3 years and twenty-six matched healthy controls were recruited. Structural and functional brain networks were examined based on diffusion tensor imaging (DTI) and functional magnetic resonance imaging (fMRI). The intergroup differences and correlation with illness duration in the patient group were surveyed. The schizophrenic patients showed lower fractional anisotropy (FA) values in the corpus callosum and corona radiata. Negative correlations of illness duration with FA values were observed in similar regions. During functional analysis, reduced functional connectivity between bilateral temporoparietal-junction (TPJ) and the posterior cingulate cortex (PCC) were found in the default mode network (DMN) in schizophrenic patients. In addition, the left TPJ showed gradually weaker functional connectivity with PCC and the medial prefrontal cortex (MPFC) in DMN as the duration of schizophrenia increased. The results suggested that early in the disease process patients have decreased connectivity in both structural and functional networks and that the weaker structural and functional connectivity negatively correlated with illness duration, which provided evidence for progressive brain abnormalities in early schizophrenia.
精神分裂症是否涉及一个渐进过程长期以来一直存在争议。本研究的目的是确定早期精神分裂症患者是否涉及一个渐进过程,这些患者未使用过药物或仅接受过短期最小剂量的抗精神病药物治疗,以避免药物效应造成的偏差。招募了28名病程长达3年的精神分裂症患者和26名匹配的健康对照者。基于扩散张量成像(DTI)和功能磁共振成像(fMRI)检查脑结构和功能网络。调查了患者组的组间差异以及与病程的相关性。精神分裂症患者胼胝体和放射冠的分数各向异性(FA)值较低。在相似区域观察到病程与FA值呈负相关。在功能分析中,发现精神分裂症患者默认模式网络(DMN)中双侧颞顶联合区(TPJ)与后扣带回皮质(PCC)之间的功能连接减少。此外,随着精神分裂症病程的增加,DMN中左侧TPJ与PCC和内侧前额叶皮质(MPFC)的功能连接逐渐减弱。结果表明,在疾病过程早期,患者的结构和功能网络连接均减少,且较弱的结构和功能连接与病程呈负相关,这为早期精神分裂症患者脑渐进性异常提供了证据。