Shen Chen-Lan, Tsai Shih-Jen, Lin Ching-Po, Yang Albert C
Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Department of General Psychiatry, Tsao-Tun Psychiatric Center, Ministry of Health and Welfare, Nantou, Taiwan.
Schizophrenia (Heidelb). 2023 Jan 5;9(1):2. doi: 10.1038/s41537-022-00328-7.
Schizophrenia is a chronic brain disorder, and neuroimaging abnormalities have been reported in different stages of the illness for decades. However, when and how these brain abnormalities occur and evolve remains undetermined. We hypothesized structural and functional brain abnormalities progress throughout the illness course at different rates in schizophrenia. A total of 115 patients with schizophrenia were recruited and stratified into three groups of different illness periods: 5-year group (illness duration: ≤5 years), 15-year group (illness duration: 12-18 years), and 25-year group (illness duration: ≥25 years); 230 healthy controls were matched by age and sex to the three groups, respectively. All participants underwent resting-state MRI scanning. Each group of patients with schizophrenia was compared with the corresponding controls in terms of voxel-based morphometry (VBM), fractional anisotropy (FA), global functional connectivity density (gFCD), and sample entropy (SampEn) abnormalities. In the 5-year group we observed only SampEn abnormalities in the putamen. In the 15-year group, we observed VBM abnormalities in the insula and cingulate gyrus and gFCD abnormalities in the temporal cortex. In the 25-year group, we observed FA abnormalities in nearly all white matter tracts, and additional VBM and gFCD abnormalities in the frontal cortex and cerebellum. By using two structural and two functional MRI analysis methods, we demonstrated that individual functional abnormalities occur in limited brain areas initially, functional connectivity and gray matter density abnormalities ensue later in wider brain areas, and structural connectivity abnormalities involving almost all white matter tracts emerge in the third decade of the course in schizophrenia.
精神分裂症是一种慢性脑部疾病，几十年来，在该疾病的不同阶段均有神经影像学异常的报道。然而，这些脑部异常何时以及如何发生和演变仍未确定。我们假设精神分裂症患者脑部的结构和功能异常在整个病程中以不同速率进展。共招募了115名精神分裂症患者，并将其分为三组不同病程的患者：5年组（病程：≤5年）、15年组（病程：12 - 18年）和25年组（病程：≥25年）；分别按年龄和性别匹配了230名健康对照者与这三组患者。所有参与者均接受静息态磁共振成像扫描。对每组精神分裂症患者与相应对照组在基于体素的形态学测量（VBM）、分数各向异性（FA）、全局功能连接密度（gFCD）和样本熵（SampEn）异常方面进行比较。在5年组中，我们仅在壳核中观察到样本熵异常。在15年组中，我们观察到岛叶和扣带回的VBM异常以及颞叶皮质的gFCD异常。在25年组中，我们观察到几乎所有白质束的FA异常，以及额叶皮质和小脑的额外VBM和gFCD异常。通过使用两种结构和两种功能磁共振成像分析方法，我们证明了个体功能异常最初出现在有限的脑区，随后功能连接和灰质密度异常出现在更广泛的脑区，而涉及几乎所有白质束的结构连接异常在精神分裂症病程的第三个十年出现。
