Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, Kunming 650101, China; Department of Psychiatry, Inner Mongolia People's Hospital, Inner Mongolia 010020, China.
Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, Kunming 650101, China; Department of Radiology, The Third Affiliated Hospital of Kunming Medical University, Kunming 650018, China.
Psychiatry Res. 2021 May;299:113862. doi: 10.1016/j.psychres.2021.113862. Epub 2021 Mar 8.
Although previous studies have consistently demonstrated that neurocognitive and social cognitive impairments are commonly observed in schizophrenia, the neural substrates of deficits of cognitive function remain unclear, especially for the chronic schizophrenia. There has been little resting-state functional magnetic resonance imaging (rs-fMRI) study of cognitive function in chronic schizophrenia. In this study we aimed to investigate the changes of rs-fMRI signals with regional homogeneity (ReHo), and explore the correlations between abnormal regional activity and cognitive function in chronic schizophrenia.
Altogether 76 subjects, 37 patients with chronic schizophrenia and 39 normal controls matched approximately for age, gender and education level were enrolled. All subjects were evaluated psychotic symptoms by Positive and Negative Syndrome Scale (PANSS) and cognitive function by Wisconsin Card Sorting Test (WCST). Conventional MRI and rs-fMRI were performed in all subjects. ReHo was calculated to measure the temporal synchronization of a given voxel and its neighboring voxels based on Kendall coefficient of concordance (KCC) in the rs-fMRI.
For the numbers of achieved categories, percentage of conceptual level response in the scores of WCST, the patient group was significantly lower than the control group (p<0.05). For the total errors, perseverative errors, non-perseverative errors, the patient group was significantly higher than the control group (p<0.05). Significant differences in ReHo were found in 11 regions (included five activated and five with decreased activity in the cerebrum and one with decreased activity in the cerebellum) in the chronic schizophrenia patients when compared with the normal controls. The ReHo map clusters that were significantly different between the two groups showed no significant correlation with clinical symptoms. Correlation of the whole brain with subscores of PANSS-T, PANSS-P, PANSS-N and WCST were significantly found in some regions.
The study identified five increased and six decreased spontaneous synchrony in the cerebrum and cerebellum in chronic schizophrenia patients compared to the normal matched controls, which were associated with positive, negative symptoms, and deficits of executive functioning.
尽管先前的研究一致表明,神经认知和社会认知障碍在精神分裂症中普遍存在,但认知功能缺陷的神经基础仍不清楚,尤其是在慢性精神分裂症中。针对慢性精神分裂症认知功能的静息态功能磁共振成像(rs-fMRI)研究较少。本研究旨在探讨慢性精神分裂症患者 rs-fMRI 信号的局部一致性(ReHo)变化,并探索异常区域活动与认知功能之间的相关性。
共纳入 76 名受试者,37 名慢性精神分裂症患者和 39 名年龄、性别和受教育程度相匹配的正常对照者。所有受试者均通过阳性和阴性症状量表(PANSS)评估精神病症状,通过威斯康星卡片分类测试(WCST)评估认知功能。所有受试者均进行常规 MRI 和 rs-fMRI 检查。基于 Kendall 协调系数(KCC)在 rs-fMRI 中计算 ReHo,以测量给定体素及其相邻体素的时间同步性。
在 WCST 得分的完成分类数和概念水平反应百分比方面,患者组明显低于对照组(p<0.05)。在总错误、持续错误、非持续错误方面,患者组明显高于对照组(p<0.05)。与正常对照组相比,慢性精神分裂症患者有 11 个区域的 ReHo 存在显著差异(包括大脑中 5 个激活区和 5 个活性降低区以及小脑中 1 个活性降低区)。两组间 ReHo 图差异有统计学意义的脑区与临床症状无明显相关性。在某些区域,全脑与 PANSS-T、PANSS-P、PANSS-N 和 WCST 子评分之间存在显著相关性。
与正常匹配对照组相比,本研究发现慢性精神分裂症患者大脑和小脑中有 5 个区域的自发性同步性增加,6 个区域的自发性同步性降低,与阳性、阴性症状和执行功能缺陷有关。