Wagner Gerd, De la Cruz Feliberto, Schachtzabel Claudia, Güllmar Daniel, Schultz C Christoph, Schlösser Ralf G, Bär Karl-Jürgen, Koch Kathrin
Department of Psychiatry and Psychotherapy, Jena University Hospital, Germany.
Department of Psychiatry and Psychotherapy, Jena University Hospital, Germany.
Cortex. 2015 May;66:35-45. doi: 10.1016/j.cortex.2015.02.004. Epub 2015 Mar 2.
Evidence suggests that cognitive deficits are a core feature of schizophrenia. The concept of "cognitive dysmetria" has been introduced to characterize disintegration of fronto-thalamic-cerebellar circuitry which constitutes a key network for a variety of neuropsychological symptoms in schizophrenia. The present multimodal study aimed at investigating effective and structural connectivity of the fronto-thalamic circuitry in schizophrenia. fMRI effective connectivity analysis using dynamic causal modeling (DCM) and diffusion tensor imaging (DTI) were combined to examine cognitive control processes in 38 patients with schizophrenia and 40 matched healthy controls. Significantly lower fractional anisotropy (FA) was detected in patients in the right anterior limb of the internal capsule (ALIC), the right thalamus and the right corpus callosum. During Stroop task performance patients demonstrated significantly lower activation relative to healthy controls in a predominantly right lateralized fronto-thalamo-cerebellar network. An abnormal effective connectivity was observed in the right connections between thalamus, anterior cingulate and dorsolateral prefrontal cortex. FA in the ALIC was significantly correlated with the thalamic BOLD signal, cognitive performance and fronto-thalamic effective connectivity in patients. Present data provide evidence for the notion of a structural and functional defect in the fronto-thalamo-cerebellar circuitry, which may be the basis of specific cognitive impairments in schizophrenia.
有证据表明,认知缺陷是精神分裂症的核心特征。“认知失调”这一概念已被引入,用以描述构成精神分裂症多种神经心理症状关键网络的额-丘脑-小脑回路的解体。本多模态研究旨在调查精神分裂症患者额-丘脑回路的有效连接性和结构连接性。将使用动态因果模型(DCM)的功能磁共振成像(fMRI)有效连接性分析与扩散张量成像(DTI)相结合, 以检查38例精神分裂症患者和40例匹配的健康对照者的认知控制过程。在内囊前肢右侧(ALIC)、右侧丘脑和右侧胼胝体中检测到患者的分数各向异性(FA)显著降低。在Stroop任务执行过程中,相对于健康对照者,患者在主要为右侧化的额-丘脑-小脑网络中表现出显著较低的激活。在丘脑、前扣带回和背外侧前额叶皮层之间的右侧连接中观察到异常的有效连接。患者ALIC中的FA与丘脑BOLD信号、认知表现和额-丘脑有效连接性显著相关。目前的数据为额-丘脑-小脑回路存在结构和功能缺陷这一观点提供了证据,这可能是精神分裂症特定认知障碍的基础。