Department of Psychiatry,University of California,San Francisco, San Francisco, CA,USA.
San Francisco VA Health Care System,San Francisco, CA,USA.
Psychol Med. 2018 Nov;48(15):2492-2499. doi: 10.1017/S003329171800003X. Epub 2018 Feb 15.
Schizophrenia (SZ) is a severe neuropsychiatric disorder associated with disrupted connectivity within the thalamic-cortico-cerebellar network. Resting-state functional connectivity studies have reported thalamic hypoconnectivity with the cerebellum and prefrontal cortex as well as thalamic hyperconnectivity with sensory cortical regions in SZ patients compared with healthy comparison participants (HCs). However, fundamental questions remain regarding the clinical significance of these connectivity abnormalities.
Resting state seed-based functional connectivity was used to investigate thalamus to whole brain connectivity using multi-site data including 183 SZ patients and 178 matched HCs. Statistical significance was based on a voxel-level FWE-corrected height threshold of p < 0.001. The relationships between positive and negative symptoms of SZ and regions of the brain demonstrating group differences in thalamic connectivity were examined.
HC and SZ participants both demonstrated widespread positive connectivity between the thalamus and cortical regions. Compared with HCs, SZ patients had reduced thalamic connectivity with bilateral cerebellum and anterior cingulate cortex. In contrast, SZ patients had greater thalamic connectivity with multiple sensory-motor regions, including bilateral pre- and post-central gyrus, middle/inferior occipital gyrus, and middle/superior temporal gyrus. Thalamus to middle temporal gyrus connectivity was positively correlated with hallucinations and delusions, while thalamus to cerebellar connectivity was negatively correlated with delusions and bizarre behavior.
Thalamic hyperconnectivity with sensory regions and hypoconnectivity with cerebellar regions in combination with their relationship to clinical features of SZ suggest that thalamic dysconnectivity may be a core neurobiological feature of SZ that underpins positive symptoms.
精神分裂症（SZ）是一种严重的神经精神疾病，与丘脑-皮质-小脑网络内的连接中断有关。与健康对照组（HCs）相比，静息态功能连接研究报告 SZ 患者丘脑与小脑和前额叶皮质的连接减少，以及与感觉皮质区域的连接增加。然而，关于这些连接异常的临床意义仍存在基本问题。
使用静息状态种子功能连接方法，使用包括 183 名 SZ 患者和 178 名匹配的 HCs 的多地点数据，研究丘脑与全脑的连接。基于体素水平的 FWE 校正高度阈值 p < 0.001 来确定统计显著性。检查 SZ 的阳性和阴性症状与大脑中显示丘脑连接差异的区域之间的关系。
HC 和 SZ 参与者的丘脑与皮质区域之间均表现出广泛的正连接。与 HCs 相比，SZ 患者双侧小脑和前扣带回的丘脑连接减少。相比之下，SZ 患者与多个感觉运动区域的丘脑连接增加，包括双侧额、顶、中/下枕叶和中/上颞叶。丘脑到颞中回的连接与幻觉和妄想呈正相关，而丘脑到小脑的连接与妄想和奇特行为呈负相关。
与感觉区域的连接增加和与小脑区域的连接减少相结合，以及它们与 SZ 临床特征的关系表明，丘脑连接中断可能是 SZ 的核心神经生物学特征，是阳性症状的基础。
