Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri.
Vanderbilt University Institute of Imaging Science, Nashville, Tennessee.
Biol Psychiatry Cogn Neurosci Neuroimaging. 2019 Nov;4(11):956-965. doi: 10.1016/j.bpsc.2019.05.017. Epub 2019 Jun 12.
The striatum is abnormal in schizophrenia and possibly represents a common neurobiological mechanism underlying psychotic disorders. Resting-state functional magnetic resonance imaging studies have not reached a consensus regarding striatal dysconnectivity in schizophrenia, although these studies generally find impaired frontoparietal and salience network connectivity. The goal of the current study was to clarify the pattern of corticostriatal connectivity, including whether corticostriatal dysconnectivity is transdiagnostic and extends into psychotic bipolar disorder.
We examined corticostriatal functional connectivity in 60 healthy subjects and 117 individuals with psychosis, including 77 with a schizophrenia spectrum illness and 40 with psychotic bipolar disorder. We conducted a cortical seed-based region-of-interest analysis with follow-up voxelwise analysis for any significant results. Further, a striatum seed-based analysis was conducted to examine group differences in connectivity between the striatum and the whole cortex.
Cortical region-of-interest analysis indicated that overall connectivity of the salience network with the striatum was reduced in psychotic disorders, which follow-up voxelwise analysis localized to the left putamen. Striatum seed-based analyses showed reduced ventral rostral putamen connectivity with the salience network portion of the medial prefrontal cortex in both schizophrenia and psychotic bipolar disorder.
The current study found evidence of transdiagnostic corticostriatal dysconnectivity in both schizophrenia and psychotic bipolar disorder, including reduced salience network connectivity, as well as reduced connectivity between the putamen and the medial prefrontal cortex. Overall, the current study points to the relative importance of salience network hypoconnectivity in psychotic disorders.
精神分裂症患者的纹状体异常，可能代表了精神障碍的共同神经生物学机制。静息态功能磁共振成像研究尚未就精神分裂症患者的纹状体连接中断达成共识，尽管这些研究通常发现前额叶和突显网络连接受损。本研究的目的是阐明皮质纹状体连接模式，包括皮质纹状体连接中断是否具有跨诊断意义，并扩展到有精神病症状的双相情感障碍。
我们检查了 60 名健康受试者和 117 名精神病患者的皮质纹状体功能连接，其中包括 77 名精神分裂症谱系障碍患者和 40 名有精神病症状的双相情感障碍患者。我们进行了皮质种子的基于区域的兴趣分析，并对任何显著结果进行了后续的体素分析。此外，还进行了纹状体种子的分析，以检查纹状体与整个大脑皮层之间的连接在组间的差异。
皮质区域兴趣分析表明，精神病患者的突显网络与纹状体的整体连接减少，后续的体素分析将其定位在左侧壳核。纹状体种子分析显示，精神分裂症和有精神病症状的双相情感障碍患者的腹侧前壳核与内侧前额叶皮质的突显网络部分的连接减少。
本研究在精神分裂症和有精神病症状的双相情感障碍患者中发现了跨诊断性皮质纹状体连接中断的证据，包括突显网络连接减少，以及壳核与内侧前额叶皮质之间的连接减少。总的来说，本研究指出了突显网络连接不足在精神病中的相对重要性。
