Choi Soo Yun, Ha Minji, Choi Sunah, Moon Sun-Young, Park Sunghyun, Kim Minah, Kwon Jun Soo
Department of Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea.
Schizophr Res. 2023 Feb;252:56-63. doi: 10.1016/j.schres.2022.12.041. Epub 2023 Jan 9.
Negative symptoms in schizophrenia include cognitive and affective dysfunction, such as diminished expression and amotivation. Although the cerebellar posterior hemisphere and vermis are involved in cognitive and affective functioning, previous studies on the neural mechanism of negative symptoms have mostly been confined to the cerebral cortex. This study aimed to investigate whether resting-state cerebellar-cerebral functional connectivity (FC) is altered in first-episode psychosis (FEP) patients and whether this connectivity is related to negative symptoms.
Resting-state functional magnetic resonance images were obtained from 38 FEP patients and 100 healthy controls (HCs). Using the posterior hemisphere and vermis of the cerebellum as seeds, whole-brain FC was compared between FEP patients and HCs. As cerebellar-parietal cortex connectivity is associated with negative symptoms and sociocognitive dysfunctions in schizophrenia patients, its correlation with negative symptoms was explored in FEP patients.
FEP patients showed hyperconnectivity between the cerebellum and bilateral frontal pole (FP), occipital pole, fusiform gyrus, right lingual gyrus, central opercular cortex, anterior middle temporal gyrus, precuneus, and subcallosal cortex. Hypoconnectivity was found between the cerebellum and left FP, right anterior supramarginal gyrus (aSMG), and cerebellum crus I. FC between the left crus II and right aSMG was negatively correlated with the severity of negative symptoms and diminished expression.
Altered FC between the cerebellum and cerebral regions related to cognitive, affective, and sensory processing was found in FEP patients and was connected to negative symptoms. These results suggest that the cerebellum plays a role in the pathophysiology of negative symptoms in schizophrenia.
精神分裂症的阴性症状包括认知和情感功能障碍，如表情减少和缺乏动机。虽然小脑后半球和蚓部参与认知和情感功能，但以往关于阴性症状神经机制的研究大多局限于大脑皮层。本研究旨在探讨首发精神病（FEP）患者静息态小脑-大脑功能连接（FC）是否改变，以及这种连接是否与阴性症状相关。
从38例FEP患者和100名健康对照者（HCs）获取静息态功能磁共振图像。以小脑后半球和蚓部为种子点，比较FEP患者和HCs之间的全脑FC。由于小脑-顶叶皮层连接与精神分裂症患者的阴性症状和社会认知功能障碍相关，因此在FEP患者中探讨其与阴性症状的相关性。
FEP患者小脑与双侧额极（FP）、枕极、梭状回、右侧舌回、中央 opercular 皮层、颞中回前部、楔前叶和胼胝体下皮层之间表现为连接增强。小脑与左侧FP、右侧前上缘回（aSMG）和小脑脚I之间发现连接减弱。左侧小脑脚II与右侧aSMG之间的FC与阴性症状的严重程度和表情减少呈负相关。
在FEP患者中发现小脑与涉及认知、情感和感觉加工的脑区之间的FC改变，且与阴性症状相关。这些结果表明小脑在精神分裂症阴性症状的病理生理学中起作用。
