Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou 310013, Zhejiang, China; Mental Health Centre & West China Brain Research Centre & Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.
Department of Psychiatry, University of Alberta, Edmonton T6G 2B7, AB, Canada.
Schizophr Res. 2023 Apr;254:155-162. doi: 10.1016/j.schres.2023.02.023. Epub 2023 Mar 7.
Aberrant resting-state functional connectivity (FC) of anterior cingulate cortex (ACC) has been implicated in the pathophysiology of schizophrenia and bipolar disorder (BP). This study investigated the subregional FC of ACC across schizophrenia and psychotic (PBP) and nonpsychotic BP (NPBP) and the relationship between brain functional alterations and clinical manifestations. A total of 174 first-episode medication-naive patients with schizophrenia (FES), 80 patients with PBP, 77 patients with NPBP and 173 demographically matched healthy controls (HCs) underwent resting-state functional magnetic resonance imaging. Brain-wide FC of ACC subregions was computed for each individual, and compared between the groups. General intelligence was evaluated using the short version of the Wechsler Adult Intelligence Scale. Relationships between FC and various clinical and cognitive variables were estimated using the skipped correlation. The FES, PBP and NPBP groups showed differing connectivity patterns in the left caudal, dorsal and perigenual ACC. Transdiagnostic dysconnectivity was found in the subregional ACC associated with cortical, limbic, striatal and cerebellar regions. Disorder-specific dysconnectivity in FES was identified between the left perigenual ACC and bilateral orbitofrontal cortex, and the left caudal ACC coupling with the default mode network (DMN) and visual processing region was correlated with psychotic symptoms. In the PBP group, FC between the left dorsal ACC and the right caudate was correlated with psychotic symptoms, and FC connected with the DMN was associated with affective symptoms. The current findings confirmed that subregional ACC dysconnectivity could be a key transdiagnostic feature and associated with differing clinical symptomology across schizophrenia and PBP.
前扣带皮层（ACC）静息态功能连接（FC）异常与精神分裂症和双相障碍（BP）的病理生理学有关。本研究调查了 ACC 的亚区 FC 在精神分裂症（FES）、精神病性（PBP）和非精神病性 BP（NPBP）中的变化，并探讨了脑功能改变与临床表现之间的关系。共纳入 174 例首次发作未用药的精神分裂症患者（FES）、80 例精神病性 BP 患者、77 例非精神病性 BP 患者和 173 名年龄、性别匹配的健康对照者（HCs），进行静息态功能磁共振成像。对每个个体的 ACC 亚区的全脑 FC 进行计算，并在组间进行比较。采用韦氏成人智力量表简式评估一般智力。采用跳过相关法估计 FC 与各种临床和认知变量之间的关系。FES、PBP 和 NPBP 组的左 ACC 尾状、背侧和旁扣带回的连接模式不同。在与皮质、边缘、纹状体和小脑区域相关的 ACC 亚区发现了跨诊断的连接不良。FES 中发现了左旁扣带回 ACC 与双侧眶额皮质之间的特定障碍连接不良，以及左 ACC 尾状与默认模式网络（DMN）和视觉处理区域的连接与精神病症状相关。在 PBP 组中，左背侧 ACC 与右侧尾状核之间的 FC 与精神病症状相关，与 DMN 连接的 FC 与情感症状相关。本研究结果证实，ACC 亚区连接不良可能是一个关键的跨诊断特征，与精神分裂症和 PBP 之间不同的临床症状有关。
