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首发未用药精神分裂症患者前额叶区域一致性增强及其与认知功能障碍/精神病理学的相关性

Enhanced Prefrontal Regional Homogeneity and Its Correlations With Cognitive Dysfunction/Psychopathology in Patients With First-Diagnosed and Drug-Naive Schizophrenia.

作者信息

Gao Shuzhan, Ming Yidan, Wang Jiayin, Gu Yuan, Ni Sulin, Lu Shuiping, Zhang Rongrong, Sun Jing, Zhang Ning, Xu Xijia

机构信息

Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China.

Department of Psychiatry, Nanjing Brain Hospital, Medical School, Nanjing University, Nanjing, China.

出版信息

Front Psychiatry. 2020 Oct 23;11:580570. doi: 10.3389/fpsyt.2020.580570. eCollection 2020.

Abstract

Schizophrenia, regarded as a neurodevelopmental disorder, is characterized by positive symptoms, negative symptoms, and cognitive dysfunction. Investigating the spontaneous brain activity in patients with schizophrenia can help us understand the underlying pathophysiologic mechanism of schizophrenia. However, results concerning abnormal neural activities and their correlations with cognitive dysfunction/psychopathology of patients with schizophrenia were inconsistent. We recruited 57 first-diagnosed and drug-naive patients with schizophrenia and 50 matched healthy controls underwent magnetic resonance imaging. The Positive and Negative Syndrome Scale (PANSS) and the MATRICS Consensus Cognitive Battery were used to assess the psychopathology/cognitive dysfunction. Regional homogeneity (ReHo) was used to explore neural activities. Correlation analyses were calculated between abnormal ReHo values and PANSS scores/standardized cognitive scores. Lastly, support vector machine analyses were conducted to evaluate the accuracy of abnormal ReHo values in distinguishing patients with schizophrenia from healthy controls. Patients with schizophrenia showed cognitive dysfunction, and increased ReHo values in the right gyrus rectus, right inferior frontal gyrus/insula and left inferior frontal gyrus/insula compared with those of healthy controls. The ReHo values in the right inferior frontal gyrus/insula were positively correlated with negative symptom scores and negatively correlated with Hopkins verbal learning test-revised/verbal learning. Our results showed that the combination of increased ReHo values in the left inferior frontal gyrus/insula and right gyrus rectus had 78.5% (84/107) accuracy, 85.96% (49/57) sensitivity, and 70.00% specificity, which were higher than other combinations. Hyperactivities were primarily located in the prefrontal regions, and increased ReHo values in the right inferior frontal gyrus/insula might reflect the severity of negative symptoms and verbal learning abilities. The combined increases of ReHo values in these regions might be an underlying biomarker in differentiating patients with schizophrenia from healthy controls.

摘要

精神分裂症被视为一种神经发育障碍,其特征为阳性症状、阴性症状和认知功能障碍。研究精神分裂症患者的大脑自发活动有助于我们理解精神分裂症潜在的病理生理机制。然而,关于精神分裂症患者异常神经活动及其与认知功能障碍/精神病理学之间相关性的研究结果并不一致。我们招募了57名首次诊断且未服用过药物的精神分裂症患者和50名匹配的健康对照者进行磁共振成像检查。使用阳性和阴性症状量表(PANSS)和MATRICS共识认知成套测验来评估精神病理学/认知功能障碍。采用局部一致性(ReHo)来探索神经活动。计算异常ReHo值与PANSS评分/标准化认知评分之间的相关性分析。最后,进行支持向量机分析以评估异常ReHo值在区分精神分裂症患者与健康对照者方面的准确性。与健康对照者相比,精神分裂症患者表现出认知功能障碍,右侧直回、右侧额下回/脑岛和左侧额下回/脑岛的ReHo值增加。右侧额下回/脑岛的ReHo值与阴性症状评分呈正相关,与修订后的霍普金斯言语学习测验/言语学习呈负相关。我们的结果表明,左侧额下回/脑岛和右侧直回ReHo值增加的组合具有78.5%(84/107)的准确性、85.96%(49/57)的敏感性和70.00%的特异性,高于其他组合。高活动主要位于前额叶区域,右侧额下回/脑岛ReHo值的增加可能反映阴性症状的严重程度和言语学习能力。这些区域ReHo值的联合增加可能是区分精神分裂症患者与健康对照者的潜在生物标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7aa7/7649771/464bb0ea050b/fpsyt-11-580570-g0001.jpg

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