Shen Haoran, Ge Likun, Cao Bo, Wei Gao-Xia, Zhang Xiangyang
CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.
Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
Int J Clin Health Psychol. 2023 Jul-Sep;23(3):100372. doi: 10.1016/j.ijchp.2023.100372. Epub 2023 Jan 28.
Our previous study has shown the cingulate cortex abnormalities in first-episode drug naïve (FEDN) schizophrenia patients with comorbid depressive symptoms. However, it remains largely unknown whether antipsychotics may induce morphometric change in cingulate cortex and its relationship with depressive symptoms. The purpose of this study was to further clarify the important role of cingulate cortex in the treatment on depressive symptoms in FEDN schizophrenia patients.
In this study, 42 FEDN schizophrenia patients were assigned into depressed patients group (DP, = 24) and non-depressed patients group (NDP, = 18) measured by the 24-item Hamilton Depression Rating Scale (HAMD). Clinical assessments and anatomical images were obtained from all patients before and after 12-week treatment with risperidone.
Although risperidone alleviated psychotic symptoms in all patients, depressive symptoms were decreased only in DP. Significant group by time interaction effects were found in the right rostral anterior cingulate cortex (rACC) and other subcortical regions in the left hemisphere. After risperidone treatment, the right rACC were increased in DP. Further, the increasing volume of right rACC was negatively associated with improvement in depressive symptoms.
These findings suggested that the abnormality of the rACC is the typical characteristics in schizophrenia with depressive symptoms. It's likely key region contributing to the neural mechanisms underlying the effects of risperidone treatment on depressive symptoms in schizophrenia.
我们之前的研究表明，首发未用药（FEDN）且伴有抑郁症状的精神分裂症患者存在扣带回皮质异常。然而，抗精神病药物是否会引起扣带回皮质形态学变化及其与抑郁症状的关系在很大程度上仍不清楚。本研究的目的是进一步阐明扣带回皮质在FEDN精神分裂症患者抑郁症状治疗中的重要作用。
在本研究中，42例FEDN精神分裂症患者根据24项汉密尔顿抑郁量表（HAMD）分为抑郁患者组（DP，n = 24）和非抑郁患者组（NDP，n = 18）。在所有患者接受利培酮治疗12周前后进行临床评估和解剖图像采集。
尽管利培酮缓解了所有患者的精神病症状，但仅DP组的抑郁症状有所减轻。在右侧喙部前扣带回皮质（rACC）和左侧半球的其他皮质下区域发现了显著的组间时间交互效应。利培酮治疗后，DP组右侧rACC体积增加。此外，右侧rACC体积的增加与抑郁症状的改善呈负相关。
这些发现表明，rACC异常是伴有抑郁症状的精神分裂症的典型特征。它可能是利培酮治疗精神分裂症抑郁症状的神经机制的关键区域。
