McGill Centre for Integrative Neuroscience, McGill University, Montreal, Canada.
McConnell Brain Imaging Centre, Montreal Neurological Institute, Montreal, Canada.
Psychol Med. 2020 Aug;50(11):1923-1936. doi: 10.1017/S0033291719002071. Epub 2019 Aug 28.
Longitudinal studies of first episode of psychosis (FEP) patients are critical to understanding the dynamic clinical factors influencing functional outcomes; negative symptoms and verbal memory (VM) deficits are two such factors that remain a therapeutic challenge. This study uses white-gray matter contrast at the inner edge of the cortex, in addition to cortical thickness, to probe changes in microstructure and their relation with negative symptoms and possible intersections with verbal memory.
T1-weighted images and clinical data were collected longitudinally for patients (N = 88) over a two-year period. Cognitive data were also collected at baseline. Relationships between baseline VM (immediate/delayed recall) and rate of change in two negative symptom dimensions, amotivation and expressivity, were assessed at the behavioral level, as well as at the level of brain structure.
VM, particularly immediate recall, was significantly and positively associated with a steeper rate of expressivity symptom decline (r = 0.32, q = 0.012). Significant interaction effects between baseline delayed recall and change in expressivity were uncovered in somatomotor regions bilaterally for both white-gray matter contrast and cortical thickness. Furthermore, interaction effects between immediate recall and change in expressivity on cortical thickness rates were uncovered across higher-order regions of the language processing network.
This study shows common neural correlates of language-related brain areas underlying expressivity and VM in FEP, suggesting deficits in these domains may be more linked to speech production rather than general cognitive capacity. Together, white-gray matter contrast and cortical thickness may optimally inform clinical investigations aiming to capture peri-cortical microstructural changes.
首发精神病（FEP）患者的纵向研究对于理解影响功能结局的动态临床因素至关重要；阴性症状和言语记忆（VM）缺陷是两个具有治疗挑战性的因素。本研究使用皮质内缘的灰白质对比，除皮质厚度外，还探测微观结构的变化及其与阴性症状的关系，以及与言语记忆的可能交集。
在两年的时间内，对患者（N=88）进行了 T1 加权图像和临床数据的纵向采集。还在基线时采集了认知数据。在行为水平以及脑结构水平上，评估了基线 VM（即时/延迟回忆）与两个阴性症状维度（动机缺乏和表达性）的变化率之间的关系。
VM，特别是即时回忆，与表达性症状下降速度的显著正相关（r=0.32，q=0.012）。在双侧运动躯体区域发现了基线延迟回忆和表达性变化之间的显著交互效应，对于灰白质对比和皮质厚度都是如此。此外，在语言处理网络的较高阶区域，发现了即时回忆和表达性变化之间的皮质厚度变化率的交互效应。
本研究显示了 FEP 中表达性和 VM 的语言相关脑区的共同神经相关性，这表明这些领域的缺陷可能与言语产生而不是一般认知能力更相关。总的来说，灰白质对比和皮质厚度可能会优化旨在捕捉皮质周围微观结构变化的临床研究。
