Department of Psychiatry and Behavioral Sciences, Vanderbilt University School of Medicine, Nashville, Tennessee.
Vanderbilt University Institute of Imaging Sciences, Nashville, Tennessee.
Biol Psychiatry. 2019 Aug 1;86(3):240-248. doi: 10.1016/j.biopsych.2018.12.016. Epub 2019 Jan 4.
Across networks, connectivity within the frontoparietal network (FPN) and cingulo-opercular network (CON) exhibits reductions earliest during healthy aging, contributing to cognitive impairment. Individuals with psychotic disorders demonstrate evidence of accelerated aging across multiple biological systems. By leveraging a large sample of patients with psychosis from early to chronic illness stages, this study sought to determine whether the CON and FPN exhibit evidence of accelerated aging in psychotic disorders, confirm associations between network efficiency and cognition, and determine whether reduced network efficiency is observed in early-stage psychosis.
Resting-state functional magnetic resonance imaging and cognitive data were obtained on 240 patients with psychotic disorder and 178 healthy control participants (HCs). Global efficiency, a measure of functional integration, was calculated for the CON, FPN, subcortical network, and visual network. Associations with age and cognition were assessed and compared between groups.
Consistent with accelerated aging, significant group by age interactions reflected significantly stronger relationships between efficiency and age in patients with psychosis than in HCs for both the CON (psychosis: r = -.37; HC: r = -.16) and FPN (psychosis: r = -.31; HC: r = -.05). Accelerated aging was not observed in either the subcortical or visual network, suggesting specificity for cognitive networks that decline earliest in healthy aging. Replicating prior findings, efficiency of both the CON and FPN correlated with cognitive function across all participants (rs > .11, ps < .031). Furthermore, patients with chronic psychosis (p = .004), but not patients with early psychosis (p = .553), exhibited significantly lower FPN efficiency compared with HCs.
Functional integration of higher-order cognitive networks is intact in early psychosis but exhibits evidence of accelerated aging, suggesting the potential for intervention targeting cognition within the early psychosis period.
在不同网络中，额顶网络（FPN）和扣带回-脑岛网络（CON）内的连接性在健康衰老过程中最早出现减少，导致认知障碍。患有精神病的个体在多个生物系统中表现出加速衰老的证据。通过利用大量处于早发至慢性疾病阶段的精神病患者样本，本研究旨在确定 CON 和 FPN 是否在精神病中存在加速老化的证据，确认网络效率与认知之间的关联，并确定在早期精神病中是否观察到网络效率降低。
对 240 名精神病患者和 178 名健康对照者（HCs）进行了静息态功能磁共振成像和认知数据采集。计算了 CON、FPN、皮质下网络和视觉网络的全局效率，作为功能整合的度量。评估了与年龄和认知的关联，并在组间进行了比较。
与加速衰老一致，效率与年龄的显著组间交互反映了精神病患者的效率与年龄之间的关系明显强于 HCs，无论是 CON（精神病：r=-.37；HC：r=-.16）还是 FPN（精神病：r=-.31；HC：r=-.05）。在皮质下或视觉网络中均未观察到加速衰老，这表明认知网络特异性最早在健康衰老中下降。CON 和 FPN 的效率与所有参与者的认知功能相关（rs>.11，ps<.031），这复制了先前的发现。此外，与 HCs 相比，慢性精神病患者（p=.004），而不是早期精神病患者（p=.553），表现出 FPN 效率显著降低。
在早期精神病中，高阶认知网络的功能整合是完整的，但表现出加速衰老的证据，这表明在早期精神病期间针对认知进行干预的潜力。
