Zhou Chao, Xue Chen, Chen Jiu, Amdanee Nousayhah, Tang Xiaowei, Zhang Hongying, Zhang Fuquan, Zhang Xiangrong, Zhang Caiyi
Department of Geriatric Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China.
Department of Radiology, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China.
Front Psychiatry. 2021 Sep 30;12:704631. doi: 10.3389/fpsyt.2021.704631. eCollection 2021.
Deficit schizophrenia (DS), which is marked by stable negative symptoms, is regarded as a homogeneous subgroup of schizophrenia. While DS patients have structurally altered nucleus accumbens (NAcc) compared to non-deficit schizophrenia (NDS) patients and healthy individuals, the investigation of NAcc functional connectivity (FC) with negative symptoms and neurocognition could provide insights into the pathophysiology of schizophrenia. 58 DS, 93 NDS, and 113 healthy controls (HCs) underwent resting-state functional magnetic resonance (rsfMRI). The right and left NAcc were respectively used as seed points to construct the functional NAcc network in whole-brain FC analysis. ANCOVA compared the differences in NAcc network FC and partial correlation analysis explored the relationships between altered FC of NAcc, negative symptoms and neurocognition. Compared to HCs, both DS and NDS patients showed decreased FC between the left NAcc (LNAcc) and bilateral middle cingulate gyrus, and between the right NAcc (RNAcc) and right middle frontal gyrus (RMFG), as well as increased FC between bilateral NAcc and bilateral lingual gyrus. Moreover, the FC between the LNAcc and bilateral calcarine gyrus (CAL) was lower in the DS group compared to NDS patients. Correlation analysis indicated that FC value of LNAcc-CAL was negatively correlated to negative symptoms. Furthermore, aberrant FC values within the NAcc network were correlated with severity of clinical symptoms and neurocognitive impairments in DS and NDS patients. This study demonstrated abnormal patterns of FC in the NAcc network between DS and NDS. The presence of altered LNAcc-CAL FC might be involved in the pathogenesis of negative symptoms in schizophrenia.
缺损型精神分裂症（DS）以稳定的阴性症状为特征，被视为精神分裂症的一个同质亚组。与非缺损型精神分裂症（NDS）患者和健康个体相比，DS患者伏隔核（NAcc）的结构发生了改变，对NAcc与阴性症状和神经认知的功能连接（FC）进行研究，可为精神分裂症的病理生理学提供见解。58名DS患者、93名NDS患者和113名健康对照者（HCs）接受了静息态功能磁共振成像（rsfMRI）。在全脑FC分析中，分别以左右NAcc作为种子点构建功能性NAcc网络。协方差分析比较了NAcc网络FC的差异，偏相关分析探讨了NAcc改变的FC、阴性症状和神经认知之间的关系。与HCs相比，DS和NDS患者的左侧NAcc（LNAcc）与双侧扣带回中部之间、右侧NAcc（RNAcc）与右侧额中回（RMFG）之间的FC均降低，双侧NAcc与双侧舌回之间的FC增加。此外，与NDS患者相比，DS组中LNAcc与双侧距状回（CAL）之间的FC更低。相关分析表明，LNAcc-CAL的FC值与阴性症状呈负相关。此外，DS和NDS患者NAcc网络内异常的FC值与临床症状严重程度和神经认知障碍相关。本研究证明了DS和NDS患者NAcc网络中FC的异常模式。LNAcc-CAL FC改变可能参与了精神分裂症阴性症状的发病机制。
