Long Yicheng, Ouyang Xuan, Liu Zhening, Chen Xudong, Hu Xinran, Lee Edwin, Chen Eric Y H, Pu Weidan, Shan Baoci, Rohrbaugh Robert M
Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, China.
Mental Health Institute, Second Xiangya Hospital, Central South University, Changsha, China.
Front Psychiatry. 2018 Aug 28;9:391. doi: 10.3389/fpsyt.2018.00391. eCollection 2018.
The study was aimed to investigate the possible associations among suicidal ideation, brain white matter (WM) integrity and cognitive deficit in first-episode schizophrenia (FES) using diffusion tensor imaging. The sample contained 18 FES patients with suicidal ideation (SI+), 45 FES patients without suicidal ideation (SI-) and 44 healthy controls. The Calgary Depression Scale for Schizophrenia was used to measure the suicidal ideation and depression symptoms. The whole brain WM integrity and three domains of cognitive function: working memory, verbal comprehension as well as processing speed were compared between the three groups. Compared with SI-, SI+ showed preserved WM integrity as indicated by significantly higher factional anisotropy (FA) or lower mean diffusivity (MD) in multiple WM tracts, and higher FA coupled with lower MD in bilateral posterior corona radiata. Compared with SI-, SI+ were more depressed and had less cognitive deficit in working memory and verbal comprehension. The fiber tracts in bilateral posterior corona radiata connect to the precuneus as shown by probabilistic tractography, and their WM integrity disruptions were found to be positively associated with the cognitive deficits in the FES patients. Preserved WM integrity may be a risk factor for suicidal ideation in FES patients. One possible explanation is that it contributes to preserved cognitive function, especially in working memory and verbal comprehension, which may be associated with greater insight and could lead to increased depression and suicidal ideation. The posterior corona radiata and the precuneus may be linked to the related biological processes.
本研究旨在利用扩散张量成像技术，调查首发精神分裂症（FES）患者自杀意念、脑白质（WM）完整性和认知缺陷之间可能存在的关联。样本包括18例有自杀意念的FES患者（SI+）、45例无自杀意念的FES患者（SI-）和44名健康对照者。使用卡尔加里精神分裂症抑郁量表来测量自杀意念和抑郁症状。比较了三组之间全脑WM完整性以及认知功能的三个领域：工作记忆、语言理解和处理速度。与SI-组相比，SI+组在多个WM束中表现出保留的WM完整性，表现为分数各向异性（FA）显著更高或平均扩散率（MD）更低，并且双侧放射冠后部FA更高且MD更低。与SI-组相比，SI+组更抑郁，在工作记忆和语言理解方面的认知缺陷更少。概率性纤维束成像显示，双侧放射冠后部的纤维束与楔前叶相连，并且发现它们的WM完整性破坏与FES患者的认知缺陷呈正相关。保留的WM完整性可能是FES患者自杀意念的一个危险因素。一种可能的解释是，它有助于保留认知功能，尤其是在工作记忆和语言理解方面，这可能与更高的洞察力有关，并可能导致抑郁和自杀意念增加。放射冠后部和楔前叶可能与相关的生物学过程有关。
