Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China.
Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China; Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan 430071, China.
Neurosci Lett. 2023 Sep 25;814:137445. doi: 10.1016/j.neulet.2023.137445. Epub 2023 Aug 18.
The anterior cingulate cortex (ACC) plays a key role in motor control, attention, and cognitive control. It is well established that schizophrenia is associated with impaired functional connectivity (FC) of the ACC pathway. So far, however, there has been little discussion about the ACC subregions function in patients with treatment-resistant schizophrenia (TRS).
This study aims to characterize resting-state functional connectivity (rs-FC) profiles of ACC subregions in patients with TRS. The association between these FC and clinical symptoms, neurocognitive function, and grey matter volume (GMV) was studied as well.
A total of 81 patients with schizophrenia (40 patients with TRS = 40, 41 patients with non-treatment-resistant schizophrenia (NTRS)) and 39 age- and gender-matched healthy controls (HC) were enrolled, and underwent structural magnetic resonance imaging (MRI), resting-state functional MRI (rs-fMRI), clinical evaluation. The ACC subregions, including subgenual ACC (sgACC), pregenual ACC (pgACC), and dorsal ACC (dACC), were selected as seed regions from the automated anatomical labelling atlas 3 (AAL3). The GMV of the ACC subregions were calculated and seed-based FC maps for all ACC subregions were generated and compared between the TRS and NTRS, HC group. Additionally, correlations between altered FC and clinical symptoms, GMV, and neurocognitive functions in the TRS patients were explored.
Compared with HC, increased FC was observed in TRS and NTRS groups between bilateral sgACC and left cuneus, right cuneus, and left lingual gyrus, while decreased FC was found between bilateral dACC and thalamic. Additionally, compared with NTRS, the TRS group showed increased FC between bilateral dACC and right cuneus and decreased FC between bilateral dACC and thalamic. The TRS group showed decreased GMV in all ACC subregions than the HC group, and there is no significant difference between the TRS group and the NTRS group.
The findings in this study suggest that disrupted FC of subregional ACC has the potential as a marker for TRS. The dysconnectivity of bilateral dACC- right cuneus and bilateral dACC-thalamus, are likely to be the unique FC profiles of TRS. These findings further our understanding of the neurobiological impairments in TRS.
前扣带皮层（ACC）在运动控制、注意力和认知控制中起着关键作用。已有研究证实精神分裂症与 ACC 通路功能连接（FC）受损有关。然而，目前关于治疗抵抗性精神分裂症（TRS）患者的 ACC 亚区功能的讨论甚少。
本研究旨在描述 TRS 患者的前扣带皮层亚区静息态功能连接（rs-FC）特征。并研究这些 FC 与临床症状、神经认知功能和灰质体积（GMV）之间的关系。
共纳入 81 名精神分裂症患者（TRS 患者 40 名，非治疗抵抗性精神分裂症患者 41 名）和 39 名年龄和性别匹配的健康对照组（HC）。所有患者均进行结构磁共振成像（MRI）、静息态功能磁共振成像（rs-fMRI）和临床评估。采用自动解剖标记图谱 3（AAL3）选择 ACC 亚区，包括前扣带皮层腹侧（dACC）、前扣带皮层背侧（dACC）和扣带回前回（pgACC）。计算 ACC 亚区的 GMV，并生成所有 ACC 亚区的种子基连接图，比较 TRS、NTRS 和 HC 组之间的差异。此外，还探讨了 TRS 患者中改变的 FC 与临床症状、GMV 和神经认知功能之间的相关性。
与 HC 组相比，TRS 组和 NTRS 组双侧 sgACC 与左侧楔前叶、右侧楔前叶和左侧舌回之间的 FC 增加，双侧 dACC 与丘脑之间的 FC 减少。此外，与 NTRS 组相比，TRS 组双侧 dACC 与右侧楔前叶和双侧 dACC 与丘脑之间的 FC 增加，双侧 dACC 与丘脑之间的 FC 减少。与 HC 组相比，TRS 组所有 ACC 亚区的 GMV 均减少，且 TRS 组与 NTRS 组之间无显著差异。
本研究结果表明，ACC 亚区的 FC 紊乱可能作为 TRS 的标志物。双侧 dACC-右侧楔前叶和双侧 dACC-丘脑的去连接，可能是 TRS 的独特 FC 特征。这些发现进一步加深了我们对 TRS 神经生物学损伤的认识。
