Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
Neurology and Neurorehabilitation Center, Kantonsspital Luzern, Luzern, Switzerland.
Schizophr Bull. 2020 Jul 8;46(4):905-915. doi: 10.1093/schbul/sbaa008.
Patients with schizophrenia frequently present deficits in gesture production and interpretation, greatly affecting their communication skills. As these gesture deficits can be found early in the course of illness and as they can predict later outcomes, exploring their neural basis may lead to a better understanding of schizophrenia. While gesturing has been reported to rely on a left lateralized network of brain regions, termed praxis network, in healthy subjects and lesioned patients, studies in patients with schizophrenia are sparse. It is currently unclear whether within-network connectivity at rest is linked to gesture deficit. Here, we compared the functional connectivity between regions of the praxis network at rest between 46 patients and 44 healthy controls. All participants completed a validated test of hand gesture performance before resting-state functional magnetic resonance imaging (fMRI) was acquired. Patients performed gestures poorer than controls in all categories and domains. In patients, we also found significantly higher resting-state functional connectivity between left precentral gyrus and bilateral superior and inferior parietal lobule. Likewise, patients had higher connectivity from right precentral gyrus to left inferior and bilateral superior parietal lobule (SPL). In contrast, they exhibited lower connectivity between bilateral superior temporal gyrus (STG). Connectivity between right precentral gyrus and left SPL, as well as connectivity between bilateral STG, correlated with gesture performance in healthy controls. We failed to detect similar correlations in patients. We suggest that altered resting-state functional connectivity within the praxis network perturbs correct gesture planning in patients, reflecting the gesture deficit often seen in schizophrenia.
精神分裂症患者经常存在手势产生和理解方面的缺陷,这极大地影响了他们的沟通能力。由于这些手势缺陷在疾病早期就可以发现,并且可以预测后期的结果,因此探索其神经基础可能有助于更好地理解精神分裂症。虽然在健康受试者和受损患者中,手势被认为依赖于一个被称为运动网络的左侧大脑区域网络,但在精神分裂症患者中的研究却很少。目前尚不清楚静息状态下的网络内连接是否与手势缺陷有关。在这里,我们比较了 46 名患者和 44 名健康对照者在静息状态下运动网络内各区域之间的功能连接。所有参与者在进行静息态功能磁共振成像(fMRI)之前都完成了一项经过验证的手部手势表现测试。患者在所有类别和领域的手势表现都比对照组差。在患者中,我们还发现左侧中央前回与双侧顶叶上、下叶之间的静息状态功能连接显著增加。同样,患者的右侧中央前回与左侧顶下叶和双侧顶叶的连接也较高。相比之下,他们的双侧颞上回之间的连接较低。右侧中央前回与左侧顶下叶之间的连接以及双侧颞上回之间的连接与健康对照组的手势表现相关。我们未能在患者中检测到类似的相关性。我们认为,运动网络内静息状态功能连接的改变扰乱了患者正确的手势规划,反映了精神分裂症中经常出现的手势缺陷。