Zhu Tingting, Wang Zixu, Zhou Chao, Fang Xinyu, Huang Chengbing, Xie Chunming, Ge Honglin, Yan Zheng, Zhang Xiangrong, Chen Jiu
Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.
Department of Psychiatry, The Third People's Hospital of Huai'an, Huaian, China.
Front Psychiatry. 2022 Sep 27;13:957685. doi: 10.3389/fpsyt.2022.957685. eCollection 2022.
Persistent negative symptoms (PNS) include both primary and secondary negative symptoms that persist after adequate treatment, and represent an unmet therapeutic need. Published magnetic resonance imaging (MRI) evidence of structural and resting-state functional brain abnormalities in schizophrenia with PNS has been inconsistent. Thus, the purpose of this meta-analysis is to identify abnormalities in structural and functional brain regions in patients with PNS compared to healthy controls.
We systematically searched PubMed, Web of Science, and Embase for structural and functional imaging studies based on five research methods, including voxel-based morphometry (VBM), diffusion tensor imaging (DTI), functional connectivity (FC), the amplitude of low-frequency fluctuation or fractional amplitude of low-frequency fluctuation (ALFF/fALFF), and regional homogeneity (ReHo). Afterward, we conducted a coordinate-based meta-analysis by using the activation likelihood estimation algorithm.
Twenty-five structural MRI studies and thirty-two functional MRI studies were included in the meta-analyses. Our analysis revealed the presence of structural alterations in patients with PNS in some brain regions including the bilateral insula, medial frontal gyrus, anterior cingulate gyrus, left amygdala, superior temporal gyrus, inferior frontal gyrus, cingulate gyrus and middle temporal gyrus, as well as functional differences in some brain regions including the bilateral precuneus, thalamus, left lentiform nucleus, posterior cingulate gyrus, medial frontal gyrus, and superior frontal gyrus.
Our study suggests that structural brain abnormalities are consistently located in the prefrontal, temporal, limbic and subcortical regions, and functional alterations are concentrated in the thalamo-cortical circuits and the default mode network (DMN). This study provides new insights for targeted treatment and intervention to delay further progression of negative symptoms.
[https://www.crd.york.ac.uk/prospero/], identifier [CRD42022338669].
持续性阴性症状（PNS）包括在充分治疗后仍持续存在的原发性和继发性阴性症状，代表了未满足的治疗需求。已发表的关于患有PNS的精神分裂症患者大脑结构和静息态功能异常的磁共振成像（MRI）证据并不一致。因此，本荟萃分析的目的是确定与健康对照相比，PNS患者大脑结构和功能区域的异常情况。
我们基于体素形态计量学（VBM）、扩散张量成像（DTI）、功能连接（FC）、低频波动幅度或低频波动分数幅度（ALFF/fALFF）以及局部一致性（ReHo）这五种研究方法，系统地检索了PubMed、科学网和Embase上的结构和功能成像研究。随后，我们使用激活似然估计算法进行了基于坐标的荟萃分析。
荟萃分析纳入了25项结构MRI研究和32项功能MRI研究。我们的分析显示，PNS患者在一些脑区存在结构改变，包括双侧岛叶、内侧额回、前扣带回、左侧杏仁核、颞上回、额下回、扣带回和颞中回，以及在一些脑区存在功能差异，包括双侧楔前叶、丘脑、左侧豆状核、后扣带回、内侧额回和额上回。
我们的研究表明，大脑结构异常一致位于前额叶、颞叶、边缘和皮质下区域，功能改变集中在丘脑 - 皮质回路和默认模式网络（DMN）。本研究为针对性治疗和干预以延缓阴性症状的进一步进展提供了新的见解。
