Hutcheson Nathan L, Sreenivasan Karthik R, Deshpande Gopikrishna, Reid Meredith A, Hadley Jennifer, White David M, Ver Hoef Lawrence, Lahti Adrienne C
Department of Psychiatry and Behavioral Neurobiology, The University of Alabama at Birmingham, Birmingham, Alabama.
Hum Brain Mapp. 2015 Apr;36(4):1442-57. doi: 10.1002/hbm.22714. Epub 2014 Dec 11.
Impairment in episodic memory is one of the most robust findings in schizophrenia. Disruptions of fronto-temporal functional connectivity that could explain some aspects of these deficits have been reported. Recent work has identified abnormal hippocampal function in unmedicated patients with schizophrenia (SZ), such as increased metabolism and glutamate content that are not always seen in medicated SZ. For these reasons, we hypothesized that altered fronto-temporal connectivity might originate from the hippocampus and might be partially restored by antipsychotic medication.
Granger causality methods were used to evaluate the effective connectivity between frontal and temporal regions in 21 unmedicated SZ and 20 matched healthy controls (HC) during performance of an episodic memory retrieval task. In 16 SZ, effective connectivity between these regions was evaluated before and after 1-week of antipsychotic treatment.
In HC, significant effective connectivity originating from the right hippocampus to frontal regions was identified. Compared to HC, unmedicated SZ showed significant altered fronto-temporal effective connectivity, including reduced right hippocampal to right medial frontal connectivity. After 1-week of antipsychotic treatment, connectivity more closely resembled the patterns observed in HC, including increased effective connectivity from the right hippocampus to frontal regions.
These results support the notion that memory disruption in schizophrenia might originate from hippocampal dysfunction and that medication restores some aspects of fronto-temporal dysconnectivity. Patterns of fronto-temporal connectivity could provide valuable biomarkers to identify new treatments for the symptoms of schizophrenia, including memory deficits.
情景记忆受损是精神分裂症最确凿的发现之一。已有报道称,额颞叶功能连接中断可解释这些缺陷的某些方面。最近的研究发现,未服用药物的精神分裂症(SZ)患者存在海马功能异常,如代谢增加和谷氨酸含量升高,而服用药物的SZ患者并不总是出现这种情况。基于这些原因,我们推测额颞叶连接改变可能源于海马体,并且可能通过抗精神病药物部分恢复。
采用格兰杰因果关系方法,在情景记忆检索任务执行过程中,评估21名未服用药物的SZ患者和20名匹配的健康对照(HC)中额叶和颞叶区域之间的有效连接。对16名SZ患者在抗精神病治疗1周前后评估这些区域之间的有效连接。
在HC中,确定了从右侧海马体到额叶区域的显著有效连接。与HC相比,未服用药物的SZ患者额颞叶有效连接显著改变,包括右侧海马体到右侧内侧额叶连接减少。抗精神病治疗1周后,连接更接近HC中观察到的模式,包括从右侧海马体到额叶区域的有效连接增加。
这些结果支持以下观点,即精神分裂症中的记忆障碍可能源于海马功能障碍,并且药物治疗可恢复额颞叶连接障碍的某些方面。额颞叶连接模式可为识别精神分裂症症状(包括记忆缺陷)的新治疗方法提供有价值的生物标志物。