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首发未使用过抗精神病药物的精神分裂症患者背外侧前额叶皮质代谢变化与认知障碍之间的关系。

Relationships between dorsolateral prefrontal cortex metabolic change and cognitive impairment in first-episode neuroleptic-naive schizophrenia patients.

作者信息

Huang Man-Li, Khoh Thong-Teck, Lu Shao-Jia, Pan Fen, Chen Jin-Kai, Hu Jian-Bo, Hu Shao-Hua, Xu Wei-Juan, Zhou Wei-Hua, Wei Ning, Qi Hong-Li, Shang De-Sheng, Xu Yi

机构信息

Department of Psychiatry, First Affiliated Hospital, College of Medicine, Zhejiang University, The Key Laboratory of Mental Disorder's Management of Zhejiang Province College of Medicine, Zhejiang University Department of Radiology, First Affiliated Hospital, College of Medicine, Zhejiang University, The Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, China.

出版信息

Medicine (Baltimore). 2017 Jun;96(25):e7228. doi: 10.1097/MD.0000000000007228.

Abstract

The present study aimed to explore the possible associations between the dorsolateral prefrontal cortex (DLPFC) metabolites and the cognitive function in first-episode schizophrenia (FES).This study included 58 patients with FES (29 males and 29 females; mean age, 22.66 ± 7.64 years) recruited from the First Affiliated Hospital, College of Medicine, Zhejiang University, and 43 locally recruited healthy controls (16 males and 27 females; mean age, 23.07 ± 7.49 years). The single-voxel proton magnetic resonance spectroscopy was used to measure the levels of N-acetylaspartate (NAA); complex of glutamate, glutamine, and γ-aminobutyric acid (Glx); choline-containing compounds; and myo-inositol in the DLPFC. The ratios of metabolites to creatine (Cr) were calculated. The cognitive function was assessed by Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery (MCCB). Correlation analysis was used to assess the relationships between the DLPFC metabolites and the cognitive function.Compared with the healthy controls, the patients with FES showed significantly reduced scores in each part of the MCCB, significantly reduced NAA/Cr, and significantly increased Glx/Cr in the left DLPFC. Poor performance in verbal learning and visual learning was correlated to the reduced NAA/Cr ratio in the left DLPFC.These findings suggest that a lower NAA/Cr ratio in the left DLPFC is associated with the cognitive deficits in patients with FES, and may be an early biochemical marker for the cognitive impairment in schizophrenia.

摘要

本研究旨在探讨首发精神分裂症(FES)患者背外侧前额叶皮质(DLPFC)代谢物与认知功能之间的潜在关联。本研究纳入了58例来自浙江大学医学院附属第一医院的FES患者(男29例,女29例;平均年龄22.66±7.64岁),以及43例当地招募的健康对照者(男16例,女27例;平均年龄23.07±7.49岁)。采用单体素质子磁共振波谱法测量DLPFC中N-乙酰天门冬氨酸(NAA)、谷氨酸、谷氨酰胺和γ-氨基丁酸复合物(Glx)、含胆碱化合物以及肌醇的水平。计算代谢物与肌酸(Cr)的比值。采用精神分裂症认知改善测量与治疗研究共识认知成套测验(MCCB)评估认知功能。采用相关性分析评估DLPFC代谢物与认知功能之间的关系。与健康对照者相比,FES患者MCCB各部分得分显著降低,左侧DLPFC的NAA/Cr显著降低,Glx/Cr显著升高。言语学习和视觉学习表现不佳与左侧DLPFC的NAA/Cr比值降低相关。这些发现表明,左侧DLPFC中较低的NAA/Cr比值与FES患者的认知缺陷相关,可能是精神分裂症认知损害的早期生化标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69ca/5484227/0e0e31a50f19/medi-96-e7228-g001.jpg

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