Department of Neuropsychiatry, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China.
Department of Psychology, Sun Yat-sen University, Guangzhou, China.
Schizophr Bull. 2017 Oct 21;43(6):1315-1328. doi: 10.1093/schbul/sbx014.
Deficit schizophrenia (DS), characterized by primary and enduring negative symptoms, has been considered as a pathophysiologically distinct schizophrenic subgroup. Neuroimaging characteristics of DS, especially functional brain network architecture, remain largely unknown. Resting-state functional magnetic resonance imaging and graph theory approaches were employed to investigate the topological organization of whole-brain functional networks of 114 male participants including 33 DS, 41 non-deficit schizophrenia (NDS) and 40 healthy controls (HCs). At the whole-brain level, both the NDS and DS group exhibited lower local efficiency (Eloc) than the HC group, implying the reduction of local specialization of brain information processing (reduced functional segregation). The DS, but not NDS group, exhibited enhanced parallel information transfer (enhanced functional integration) as determined by smaller characteristic path length (Lp) and higher global efficiency (Eglob). The Lp and Eglob presented significant correlations with Brief Psychiatric Rating Scale (BPRS) total score in the DS group. At the nodal level, both the NDS and DS groups showed higher functional connectivity in the inferior frontal gyrus and hippocampus, and lower connectivity in the visual areas and striatum than the controls. The DS group exhibited higher nodal connectivity in the right inferior temporal gyrus than the NDS and HC group. The diminished expression of Scale for the Assessment of Negative Symptoms (SANS) subfactors negatively correlated with nodal connectivity of right putamen, while asociality/amotivation positively correlated with right hippocampus across whole patients. We highlighted the convergence and divergence of brain functional network dysfunctions in patients with DS and NDS, which provides crucial insights into pathophysiological mechanisms of the 2 schizophrenic subtypes.
缺陷型精神分裂症(DS)以原发性和持续性阴性症状为特征,被认为是一种具有不同病理生理机制的精神分裂症亚组。DS 的神经影像学特征,尤其是功能脑网络结构,仍知之甚少。本研究采用静息态功能磁共振成像和图论方法,对 114 名男性参与者(包括 33 名 DS 患者、41 名非缺陷型精神分裂症患者和 40 名健康对照者)的全脑功能网络拓扑结构进行了研究。在全脑水平上,DS 组和 NDS 组的局部效率(Eloc)均低于 HC 组,这表明大脑信息处理的局部专业化程度降低(功能分离减少)。DS 组而不是 NDS 组的特征路径长度(Lp)更小、全局效率(Eglob)更高,表明平行信息传递增强(功能整合增强)。Lp 和 Eglob 与 DS 组的简明精神病评定量表(BPRS)总分呈显著相关。在节点水平上,NDS 组和 DS 组的额下回和海马体的功能连接性均高于对照组,而视觉区域和纹状体的功能连接性低于对照组。DS 组右侧颞下回的节点连接性高于 NDS 组和 HC 组。负性症状评定量表(SANS)子因子的表达减少与右侧壳核的节点连接性呈负相关,而社交退缩/动机缺失与全患者的右侧海马体呈正相关。我们强调了 DS 和 NDS 患者脑功能网络功能障碍的趋同和发散,这为这两种精神分裂症亚型的病理生理机制提供了重要的见解。