在维持视空间工作记忆期间，首发精神病中临床和行为表型的区分。
Differentiating between clinical and behavioral phenotypes in first-episode psychosis during maintenance of visuospatial working memory.
机构信息
University of Pittsburgh, Department of Psychiatry, Pittsburgh, PA, United States.
University of Pittsburgh, Department of Psychiatry, Pittsburgh, PA, United States.
出版信息
Schizophr Res. 2018 Jul;197:357-364. doi: 10.1016/j.schres.2017.11.012. Epub 2017 Nov 11.
INTRODUCTION
We probed the neural basis of working memory in individuals with first episode of psychosis (FEP) and assessed how these neural abnormalities are associated with behavioral performance and/or core to psychosis pathophysiology.
METHODS
FEP (N=35) and matched controls (N=25) performed a visuospatial working memory task during fMRI acquisition. We isolated neural activity during the maintenance period and examined neural activity within regions typically engaged during a working memory task. Functional connectivity estimates were derived using psychophysiological interaction analysis. We examined correlations between brain function and behavioral performance and clinical symptomatology.
RESULTS
FEP had reduced accuracy and slower reaction times compared to controls (p<0.05, q<0.05). During the maintenance period, FEP exhibited reduced right dorsolateral prefrontal cortex (DLPFC) activation compared to controls (p=0.007, q=0.01), even when behavioral performance was matched between groups (p=0.01, q=0.03). Unlike controls, FEP failed to show increased dorsal anterior cingulate (dACC) activity with increased load level (p=0.02, q=0.06). Compared to controls, FEP showed increased negative DLPFC-dACC coupling during the maintenance period (p=0.05). Increased DLPFC activation was significantly associated with greater negative symptoms (p<0.005, q=0.02), while greater dACC activation was significantly associated with better performance in FEP (p<0.05, q<0.17).
CONCLUSION
WM impairment in psychosis may be specific to abnormalities in the ability of frontal systems processing executive commands (DLPFC) and monitoring performance (dACC) during the maintenance of information. Our results add to accumulating evidence indicating that DLPFC abnormalities may be core to psychosis psychopathology. We also provide new insights regarding how DLPFC abnormalities may undermine dACC processing during the maintenance of information.
简介
我们探讨了首发精神病患者（FEP）的工作记忆的神经基础，并评估了这些神经异常与行为表现和/或精神病理学的核心是如何相关的。
方法
FEP（N=35）和匹配的对照组（N=25）在 fMRI 采集期间执行了视觉空间工作记忆任务。我们在维持期内分离了神经活动，并检查了通常在工作记忆任务中参与的区域内的神经活动。使用心理生理交互分析得出功能连接估计。我们检查了大脑功能与行为表现和临床症状之间的相关性。
结果
与对照组相比，FEP 的准确性较低，反应时间较慢（p<0.05，q<0.05）。在维持期内，与对照组相比，FEP 的右侧背外侧前额叶皮层（DLPFC）激活减少（p=0.007，q=0.01），即使在两组的行为表现相匹配时（p=0.01，q=0.03）。与对照组不同，FEP 未能随着负荷水平的增加而显示出背侧前扣带（dACC）活动的增加（p=0.02，q=0.06）。与对照组相比，FEP 在维持期内显示出增加的负 DLPFC-dACC 耦合（p=0.05）。DLPFC 激活的增加与更严重的阴性症状显著相关（p<0.005，q=0.02），而 dACC 激活的增加与 FEP 的更好表现显著相关（p<0.05，q=0.17）。
结论
精神病中的 WM 损伤可能是由于前额叶系统处理执行命令（DLPFC）和监测表现（dACC）的能力异常而导致的，这种异常发生在信息维持期间。我们的结果增加了越来越多的证据，表明 DLPFC 异常可能是精神病病理学的核心。我们还提供了关于 DLPFC 异常如何在信息维持期间破坏 dACC 处理的新见解。
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