Center for Neuropsychiatric Schizophrenia Research (CNSR) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, University of Copenhagen, Denmark.
Functional Imaging Unit, Department of Clinical Physiology and Nuclear Medicine, Rigshospitalet Glostrup, Denmark.
Schizophr Bull. 2018 Oct 17;44(6):1332-1340. doi: 10.1093/schbul/sbx171.
The investigation of large-scale intrinsic connectivity networks in antipsychotic-naïve first-episode schizophrenia increases our understanding of system-level cerebral dysfunction in schizophrenia while enabling control of confounding effects of medication and disease progression. Reports on functional connectivity in antipsychotic-naïve patients have been mixed and the relation between network alterations, psychopathology and cognition is unclear.
A total number of 47 patients with first-episode schizophrenia who had never received antipsychotic medication and 47 healthy controls were scanned with functional magnetic resonance imaging under resting conditions. Main outcome measures were differences in functional connectivity between groups and the relationship between network alterations, psychopathology and cognition.
Altered connectivity was found between right central executive network (CEN) and right ventral attention network (VAN) (patients > controls, P = .001), left CEN and left VAN (P = .002), and between posterior default mode network and auditory network (P = .006). Association between network connectivity and clinical characteristics was found as interactions between the effects of group and sustained attention (P = .005) and between group and processing speed (P = .007) on the connectivity between right CEN and right VAN.
Our findings suggest that the early phase of schizophrenia is characterized by increased connectivity between fronto-parietal networks suggested to be involved in the control of cognitive and sensory functions. Moreover, the present study suggests that the problem of not disengaging the VAN leads to difficulties with attention and possibly subjective awareness.
研究未经抗精神病药物治疗的首发精神分裂症患者的大规模固有连接网络，可增加我们对精神分裂症大脑系统功能障碍的认识，并可控制药物和疾病进展的混杂影响。未经抗精神病药物治疗的患者的功能连接报告结果不一，网络改变与精神病理学和认知之间的关系尚不清楚。
共纳入 47 例从未接受过抗精神病药物治疗的首发精神分裂症患者和 47 名健康对照者，在静息状态下进行功能磁共振成像扫描。主要观察指标为组间功能连接的差异以及网络改变与精神病理学和认知的关系。
发现右侧中央执行网络（CEN）和右侧腹侧注意网络（VAN）之间的连接改变（患者>对照组，P=0.001），左侧 CEN 和左侧 VAN 之间的连接改变（P=0.002），以及后默认模式网络和听觉网络之间的连接改变（P=0.006）。网络连接与临床特征之间存在关联，表现为组间效应与持续注意力（P=0.005）和组间效应与处理速度（P=0.007）之间的相互作用，对右侧 CEN 和右侧 VAN 之间的连接有影响。
本研究结果表明，精神分裂症早期阶段的特征是额顶网络之间的连接增加，这些网络被认为与认知和感觉功能的控制有关。此外，本研究表明，VAN 无法脱离的问题导致注意力和可能的主观意识出现困难。
