Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
Institute of Mental Health, 10, Buangkok View, Singapore, Republic of Singapore.
J Neural Transm (Vienna). 2020 Jul;127(7):1073-1079. doi: 10.1007/s00702-020-02207-w. Epub 2020 May 20.
The considerable clinical heterogeneity in schizophrenia makes elucidation of its neurobiology challenging. Subtyping the disorder is one way to reduce this heterogeneity and deficit status is one such categorization based on the prominence of negative symptoms. We aimed to utilize diffusion tensor imaging (DTI) to identify unique white matter cerebral changes in deficit schizophrenia (DS) compared with non-deficit schizophrenia (NDS) and healthy controls (HC) in an Asian sample. A total of 289 subjects (111 HC, 133 NDS and 45 DS) underwent DTI and completed rating scales which assessed the severity of psychopathology, psychosocial functioning and premorbid intelligence.We found that DS patients had fractional anisotropy (FA) reductions in the Body of the Corpus Callosum (BCC) and right Posterior Thalamic Radiation (PTR) regions relative to HCs, and FA reductions in the right PTR relative to NDS patients. NDS patients had FA reductions of the BCC and right PTR relative to HCs. Binomial logistic regression analyses revealed that FA reductions of the right PTR FA was an independent predictor of deficit status. The identified brain white matter changes especially in the PTR relate to deficits of cognitive control and emotional awareness, which may underlie psychopathology associated with deficit status like inattention and affective blunting. These potential biomarkers of DS warrant further examination to determine their utility for monitoring illness progression and intervention response in schizophrenia.
精神分裂症的临床异质性很大，这使得阐明其神经生物学机制具有挑战性。对该疾病进行亚型分类是减少这种异质性的一种方法，而根据阴性症状的突出程度进行分类是其中一种方法。我们旨在利用弥散张量成像（DTI）来识别亚洲样本中缺陷型精神分裂症（DS）与非缺陷型精神分裂症（NDS）和健康对照组（HC）之间独特的脑白质变化。共有 289 名受试者（111 名 HC、133 名 NDS 和 45 名 DS）接受了 DTI 检查，并完成了评估精神病理学严重程度、心理社会功能和前期智力的量表。我们发现 DS 患者的胼胝体体部（BCC）和右侧丘脑后辐射（PTR）区域的各向异性分数（FA）较 HC 降低，而右侧 PTR 的 FA 较 NDS 患者降低。NDS 患者的 BCC 和右侧 PTR 的 FA 较 HC 降低。二项逻辑回归分析显示，右侧 PTR 的 FA 降低是缺陷状态的独立预测因子。所识别的脑白质变化，特别是在 PTR 中，与认知控制和情绪意识的缺陷有关，这可能是与缺陷状态相关的精神病理学的基础，如注意力不集中和情感迟钝。这些 DS 的潜在生物标志物值得进一步研究，以确定它们在监测精神分裂症疾病进展和干预反应中的效用。
