Liu Congcong, Kim Woo-Sung, Shen Jie, Tsogt Uyanga, Kang Nam-In, Lee Keon-Hak, Chung Young-Chul
Department of Psychiatry, Medical School, Jeonbuk National University, Jeonju, South Korea.
Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, South Korea.
Front Psychiatry. 2022 May 18;13:802025. doi: 10.3389/fpsyt.2022.802025. eCollection 2022.
The relationship between brain structural changes and cognitive dysfunction in schizophrenia is strong. However, few studies have investigated both neuroanatomical abnormalities and cognitive dysfunction in treatment-resistant schizophrenia (TRS). We examined neuroanatomical markers and cognitive function between patients with TRS or early-stage schizophrenia (ES-S) and healthy controls (HCs). Relationships between neuroanatomical markers and cognitive function in the patient groups were also investigated.
A total of 46 and 45 patients with TRS and ES-S and 61 HCs underwent structural magnetic resonance imaging (MRI) brain scanning and comprehensive cognitive tests. MRI scans were analyzed using the FreeSurfer to investigate differences in cortical surface area (CSA), cortical thickness (CT), cortical volume (CV), and subcortical volume (SCV) among the groups. Four cognitive domains (attention, verbal memory, executive function, and language) were assessed. Comparisons of neuroanatomical and cognitive function results among the three groups were performed.
A widespread reduction in CT was observed in patients with TRS compared to HCs, but differences in cortical thinning between TRS and ES-S patients were mainly limited to the inferior frontal gyrus and insula. Several subcortical structures (accumbens, amygdala, hippocampus, putamen, thalamus and ventricles) were significantly altered in TRS patients compared to both ES-S patients and HCs. Performance in the verbal memory domain was significantly worse in TRS patients compared to ES-S patients. A positive relationship between the thickness of the left middle temporal gyrus and the composite score for language was identified in patients with ES-S.
Our findings suggest significant cognitive impairment and reductions in CT and SCV in individuals with TRS compared to those with ES-S and HCs. These abnormalities could act as biomarkers for earlier identification of TRS.
精神分裂症患者脑结构变化与认知功能障碍之间的关系密切。然而，很少有研究同时调查难治性精神分裂症（TRS）的神经解剖学异常和认知功能障碍。我们研究了TRS或早期精神分裂症（ES-S）患者与健康对照（HCs）之间的神经解剖学标志物和认知功能。还研究了患者组中神经解剖学标志物与认知功能之间的关系。
共有46例TRS患者、45例ES-S患者和61例HCs接受了结构磁共振成像（MRI）脑部扫描和全面的认知测试。使用FreeSurfer分析MRI扫描，以研究各组之间皮质表面积（CSA）、皮质厚度（CT）、皮质体积（CV）和皮质下体积（SCV）的差异。评估了四个认知领域（注意力、言语记忆、执行功能和语言）。对三组之间的神经解剖学和认知功能结果进行了比较。
与HCs相比，TRS患者的CT普遍降低，但TRS和ES-S患者之间皮质变薄的差异主要局限于额下回和脑岛。与ES-S患者和HCs相比，TRS患者的几个皮质下结构（伏隔核、杏仁核、海马体、壳核、丘脑和脑室）有显著改变。与ES-S患者相比，TRS患者的言语记忆领域表现明显更差。在ES-S患者中，发现左侧颞中回厚度与语言综合评分之间存在正相关。
我们的研究结果表明，与ES-S患者和HCs相比，TRS患者存在明显的认知障碍以及CT和SCV降低。这些异常可作为早期识别TRS的生物标志物。
