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慢性药物治疗对精神分裂症患者功能脑网络连接的影响。

Effects of Chronic Pharmacological Treatment on Functional Brain Network Connectivity in Patients with Schizophrenia.

机构信息

Peking University Sixth Hospital, Peking University Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China.

Center for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou 311121, China.

出版信息

Psychiatry Res. 2021 Jan;295:113338. doi: 10.1016/j.psychres.2020.113338. Epub 2020 Aug 5.

Abstract

Schizophrenia is characterized by the dysfunction of various brain networks. Previous studies suggested that pharmacological treatments for schizophrenia induce functional changes in localized brain regions. However, the effects of antipsychotic treatments on brain networks associated with symptom improvement are still elusive. The elucidation of antipsychotic-induced functional brain changes is essential for the development of biologically informed treatment strategies. Forty-five healthy controls and 44 patients with schizophrenia underwent resting-state fMRI scans at baseline. The patients underwent a second scan after 6 weeks of antipsychotic treatment. At baseline, patients exhibited a significant decrease in functional connectivity of the cingulate gyrus in the default mode network compared to healthy controls, and this decrease was negatively correlated with symptom severity. Clinical improvements were observed after 6 weeks treatment, accompanied by an increase in functional connectivity of the cingulate gyrus in the default mode network and the inferior parietal lobule in the executive control network. The changes in functional connectivity of the inferior parietal lobule were significantly correlated with symptom improvement. These longitudinal neuroimaging findings suggest that schizophrenia might be an outcome of the disruption of the optimal balance of brain networks, and reestablishing this balance through antipsychotic treatment may result in clinical symptom improvement.

摘要

精神分裂症的特征是各种大脑网络的功能障碍。先前的研究表明,精神分裂症的药物治疗会引起局部脑区的功能变化。然而,抗精神病药物治疗对与症状改善相关的大脑网络的影响仍难以捉摸。阐明抗精神病药物引起的功能性大脑变化对于开发基于生物学的治疗策略至关重要。45 名健康对照者和 44 名精神分裂症患者在基线时接受静息态 fMRI 扫描。患者在抗精神病治疗 6 周后进行第二次扫描。在基线时,与健康对照组相比,患者的默认模式网络中的扣带回的功能连接显著降低,而这种降低与症状严重程度呈负相关。经过 6 周的治疗后观察到临床改善,伴随着默认模式网络中的扣带回和执行控制网络中的下顶叶的功能连接增加。下顶叶的功能连接变化与症状改善显著相关。这些纵向神经影像学发现表明,精神分裂症可能是大脑网络最佳平衡破坏的结果,通过抗精神病药物治疗重新建立这种平衡可能导致临床症状的改善。

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