Vogel Tobias, Smieskova Renata, Schmidt André, Walter Anna, Harrisberger Fabienne, Eckert Anne, Lang Undine E, Riecher-Rössler Anita, Graf Marc, Borgwardt Stefan
Psychiatric University Clinics (UPK) Basel, Wilhelm Klein-Strasse 27, Basel, Switzerland; Medical Image Analysis Center, University Hospital Basel, Switzerland.
Psychiatric University Clinics (UPK) Basel, Wilhelm Klein-Strasse 27, Basel, Switzerland; Medical Image Analysis Center, University Hospital Basel, Switzerland; Neurobiology Laboratory for Brain Aging and Mental Health, Psychiatric Clinics of the University of Basel, Basel, Switzerland; Transfacultary Research Platform, Molecular & Cognitive Neuroscience, University of Basel, Basel, Switzerland.
Schizophr Res. 2016 Aug;175(1-3):20-26. doi: 10.1016/j.schres.2016.03.033. Epub 2016 Apr 18.
Impairment in working memory (WM) is a core symptom in schizophrenia. However, little is known about how clinical features influence functional brain activity specific to WM processing during the development of first-episode psychosis (FEP) to schizophrenia (SZ). We compared functional WM-specific brain activity in FEP and SZ patients, including the effects of the duration of illness, psychopathological factors and antipsychotic medication.
Cross-sectional study of male FEP (n=22) and SZ (n=20) patients performing an n-back task when undergoing functional magnetic resonance imaging (fMRI). Clinical features were collected by semi-structured interviews and medical records.
The SZ group performed significantly worse than the FEP group in the 2-back condition. The SZ group also showed significantly higher activation in the left superior frontal gyrus in the 2-back versus 0-back condition (2-back>0-back). This frontal activation correlated positively with negative symptoms and with cumulative antipsychotic medication during the year before the fMRI examination. There were no significant correlations between activation and duration of illness.
There was greater frontal neural activation in SZ than in FEP. This indicated differences in WM processing, and was significantly related to cumulative antipsychotic exposure and negative symptoms, but not to the duration of illness.
工作记忆（WM）损害是精神分裂症的核心症状。然而，对于首发精神病（FEP）发展为精神分裂症（SZ）过程中临床特征如何影响WM处理特定的功能性脑活动，我们知之甚少。我们比较了FEP和SZ患者中特定于WM的功能性脑活动，包括病程、精神病理因素和抗精神病药物治疗的影响。
对男性FEP（n = 22）和SZ（n = 20）患者进行横断面研究，在他们接受功能磁共振成像（fMRI）时执行n-back任务。通过半结构化访谈和病历收集临床特征。
在2-back条件下，SZ组的表现显著差于FEP组。SZ组在2-back与0-back条件下相比，左侧额上回也显示出显著更高的激活（2-back > 0-back）。这种额叶激活与阴性症状以及fMRI检查前一年的累积抗精神病药物治疗呈正相关。激活与病程之间无显著相关性。
SZ患者的额叶神经激活比FEP患者更强。这表明WM处理存在差异，并且与累积抗精神病药物暴露和阴性症状显著相关，但与病程无关。
