Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, PR China.
The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, Center for Information in Medicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, PR China.
Schizophr Res. 2021 Oct;236:29-37. doi: 10.1016/j.schres.2021.07.038. Epub 2021 Aug 5.
Brain dynamics abnormalities in the triple-network, which involves the salience network (SN), the default mode network (DMN) and the central executive network (CEN), have been reported in schizophrenia. However, it remains to be clarified how antipsychotics affect dynamic functional connectivity (DFC) within the triple-network and whether differences in clinical outcomes are associated with varying levels of network model dysfunction.
Resting-state functional magnetic resonance imaging scans were obtained from 64 first-episode schizophrenia patients (SZ) and 67 healthy controls (HC). All patients were scanned before and after 12-week antipsychotic treatment and the HC were scanned only at baseline.
At baseline, SZ participants showed significantly reduced dynamic functional interactions across the triple-network compared to HC. The SZ group displayed a pattern of reduction in resting-state DFC among the triple-network compared with HC. After medication, the mean dynamic network interaction index (dNII) value was improved. A significant quadratic relation was observed between longitudinal change of mean dNII and the reduction ratio of PANSS total score within the SZ group. The DFC within inter-network (between DMN and SN, and between DMN and CEN) and intra-network connections of DMN were significantly higher relative to baseline. Intra-SN DFC, intra-DMN DFC and DFC between SN and DMN were found to be predictive of clinical features at baseline. Intra-CEN DFC and DFC between DMN and CEN were predictive of treatment response.
Aberrant brain dynamics in the triple-network could be regulated with medication. DFC organization in the triple network was found to predict the clinical outcome.
在精神分裂症中,已报道三重网络(包括突显网络[SN]、默认模式网络[DMN]和中央执行网络[CEN])的脑动力学异常。然而,抗精神病药如何影响三重网络内的动态功能连接(DFC),以及临床结果的差异是否与网络模型功能障碍的不同程度相关,仍有待阐明。
对 64 例首发精神分裂症患者(SZ)和 67 例健康对照者(HC)进行静息态功能磁共振成像扫描。所有患者在抗精神病药物治疗前和 12 周后进行扫描,而 HC 仅在基线时进行扫描。
在基线时,与 HC 相比,SZ 参与者的三重网络之间的动态功能相互作用明显减少。与 HC 相比,SZ 组在静息状态下显示出三重网络间 DFC 的减少模式。药物治疗后,平均动态网络相互作用指数(dNII)值有所改善。在 SZ 组中,纵向变化的平均 dNII 与 PANSS 总分的降低比率之间观察到显著的二次关系。在网络间(DMN 和 SN 之间以及 DMN 和 CEN 之间)和 DMN 内连接的 DFC 与基线相比显著增加。SN 内 DFC、DMN 内 DFC 和 SN 与 DMN 之间的 DFC 在基线时与临床特征相关。CEN 内 DFC 和 DMN 与 CEN 之间的 DFC 可预测治疗反应。
三重网络中的脑动力学异常可以通过药物治疗来调节。三重网络中的 DFC 组织可预测临床结局。