From the Department of Psychiatry, Clinical Neuroscience Division, Laboratory of Neuroscience, VA Boston Healthcare System, Brockton Division, Brockton, Mass.; Harvard Medical School, Boston; the Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston; the Department of Radiology, Surgical Planning Laboratory, MRI Division, Brigham and Women's Hospital, Harvard Medical School, Boston; the Department of Psychology, University of Massachusetts, Boston; and the Laureate Institute for Brain Research, Tulsa, Okla.
Am J Psychiatry. 2017 Nov 1;174(11):1102-1111. doi: 10.1176/appi.ajp.2017.16091046. Epub 2017 Sep 15.
The striatum receives segregated and integrative white matter tracts from the cortex facilitating information processing in the cortico-basal ganglia network. The authors examined both types of input tracts in the striatal associative loop in chronic schizophrenia patients and healthy control subjects.
Structural and diffusion MRI scans were acquired on a 3-T system from 26 chronic schizophrenia patients and 26 matched healthy control subjects. Using FreeSurfer, the associative cortex was parcellated into ventrolateral prefrontal cortex and dorsolateral prefrontal cortex subregions. The striatum was manually parcellated into its associative and sensorimotor functional subregions. Fractional anisotropy and normalized streamlines, an estimate of fiber counts, were assessed in four frontostriatal tracts (dorsolateral prefrontal cortex-associative striatum, dorsolateral prefrontal cortex-sensorimotor striatum, ventrolateral prefrontal cortex-associative striatum, and ventrolateral prefrontal cortex-sensorimotor striatum). Furthermore, these measures were correlated with a measure of cognitive control, the Trail-Making Test, Part B.
Results showed reduced fractional anisotropy and fewer streamlines in chronic schizophrenia patients for all four tracts, both segregated and integrative. Post hoc t tests showed reduced fractional anisotropy in the left ventrolateral prefrontal cortex-associative striatum and left ventrolateral prefrontal cortex-sensorimotor striatum and fewer normalized streamlines in the right dorsolateral prefrontal cortex-sensorimotor striatum and in the left and right ventrolateral prefrontal cortex-sensorimotor striatum in chronic schizophrenia patients. Furthermore, normalized streamlines in the right dorsolateral prefrontal cortex-sensorimotor striatum negatively correlated with Trail-Making Test, Part B, time spent in healthy control subjects but not in chronic schizophrenia patients.
These findings demonstrated that structural connectivity is reduced in both segregated and integrative tracts in the striatal associative loop in chronic schizophrenia and that reduced normalized streamlines in the right-hemisphere dorsolateral prefrontal cortex-sensorimotor striatum predicted worse cognitive control in healthy control subjects but not in chronic schizophrenia patients, suggesting a loss of a "normal" brain-behavior correlation in chronic schizophrenia.
纹状体接收来自皮质的分隔和整合的白质束,促进皮质基底节网络中的信息处理。作者在慢性精神分裂症患者和健康对照组中检查了纹状体联合环路中的这两种输入束。
在 3T 系统上对 26 名慢性精神分裂症患者和 26 名匹配的健康对照组进行结构和扩散 MRI 扫描。使用 FreeSurfer,将联合皮质分为腹外侧前额叶皮质和背外侧前额叶皮质亚区。手动将纹状体分为其联合和感觉运动功能亚区。在四个额纹状体束(背外侧前额叶皮质-联合纹状体、背外侧前额叶皮质-感觉运动纹状体、腹外侧前额叶皮质-联合纹状体和腹外侧前额叶皮质-感觉运动纹状体)中评估各向异性分数和归一化流线,估计纤维计数。此外,将这些测量结果与认知控制的一项测量(连线测试,B 部分)进行相关性分析。
结果显示,所有四条束(分隔和整合)的慢性精神分裂症患者的各向异性分数降低,流线减少。事后 t 检验显示,慢性精神分裂症患者的左侧腹外侧前额叶皮质-联合纹状体和左侧腹外侧前额叶皮质-感觉运动纹状体的各向异性分数降低,右侧背外侧前额叶皮质-感觉运动纹状体和左侧和右侧腹外侧前额叶皮质-感觉运动纹状体的归一化流线减少。此外,右侧背外侧前额叶皮质-感觉运动纹状体的归一化流线与连线测试,B 部分,健康对照组的用时呈负相关,但与慢性精神分裂症患者的用时不相关。
这些发现表明,慢性精神分裂症患者纹状体联合环路中的分隔和整合束的结构连接减少,右侧背外侧前额叶皮质-感觉运动纹状体的归一化流线减少,预示着健康对照组的认知控制能力更差,但慢性精神分裂症患者的认知控制能力则不会,这表明慢性精神分裂症中存在“正常”脑-行为相关性的丧失。