Pu Shenghong, Nakagome Kazuyuki, Itakura Masashi, Ohtachi Hiroaki, Iwata Masaaki, Nagata Izumi, Kaneko Koichi
Division of Neuropsychiatry, Department of Brain and Neuroscience, Faculty of Medicine, Tottori University, Yonago, Japan.
National Center of Neurology and Psychiatry, Kodaira, Japan.
Front Psychiatry. 2018 Feb 2;9:16. doi: 10.3389/fpsyt.2018.00016. eCollection 2018.
Although prior studies identified a relationship between cognitive insight and subjective quality of life (QOL) in patients with schizophrenia, the brain regions mediating this relationship remain unknown. Recent studies have shown that the ventrolateral prefrontal cortex may be particularly important for cognitive insight in individuals with schizophrenia. Here, we examined whether frontotemporal function mediates the relationship between cognitive insight and QOL in 64 participants, including 32 patients with schizophrenia and 32 healthy controls. Cognitive insight was measured using the Beck Cognitive Insight Scale (BCIS), while participants' subjective QOL was assessed using the Medical Outcomes Study 36-item Short-form Health Survey. Frontotemporal function was evaluated during a verbal fluency task using multichannel near-infrared spectroscopy. Consistent with previous findings, we found that frontotemporal function was impaired in patients with schizophrenia. Interestingly, our data also revealed that the right ventrolateral PFC and the right anterior part of the temporal cortex significantly mediated the relationship between the self-reflectiveness (SR) subscale of the BCIS and subjective QOL. These findings suggest that cognitive insight, particularly SR, is associated with subjective QOL in patients with schizophrenia right frontotemporal function. The findings of this study provide important insight into a QOL model of schizophrenia, which may guide the development of cost-effective interventions that target frontotemporal function in patients with schizophrenia.
尽管先前的研究确定了精神分裂症患者认知洞察力与主观生活质量（QOL）之间的关系，但介导这种关系的脑区仍不清楚。最近的研究表明，腹外侧前额叶皮层可能对精神分裂症患者的认知洞察力尤为重要。在此，我们研究了额颞叶功能是否介导了64名参与者（包括32名精神分裂症患者和32名健康对照）的认知洞察力与生活质量之间的关系。使用贝克认知洞察力量表（BCIS）测量认知洞察力，而使用医学结局研究36项简短健康调查评估参与者的主观生活质量。在言语流畅性任务期间，使用多通道近红外光谱评估额颞叶功能。与先前的研究结果一致，我们发现精神分裂症患者的额颞叶功能受损。有趣的是，我们的数据还显示，右侧腹外侧前额叶皮层和颞叶皮层的右侧前部显著介导了BCIS的自我反思性（SR）子量表与主观生活质量之间的关系。这些发现表明，认知洞察力，特别是SR，与精神分裂症患者的主观生活质量及右侧额颞叶功能相关。本研究结果为精神分裂症的生活质量模型提供了重要见解，这可能指导针对精神分裂症患者额颞叶功能的经济有效的干预措施的开发。
