Li Yu-Ting, Zhang Chi, Han Jia-Cheng, Shang Yu-Xuan, Chen Zhu-Hong, Cui Guang-Bin, Wang Wen
Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China.
Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China.
Ther Adv Psychopharmacol. 2024 May 4;14:20451253241243290. doi: 10.1177/20451253241243290. eCollection 2024.
Cognitive dysfunctions are one of the key symptoms of schizophrenia (SZ) and major depressive disorder (MDD), which exist not only during the onset of diseases but also before the onset, even after the remission of psychiatric symptoms. With the development of neuroimaging techniques, these non-invasive approaches provide valuable insights into the underlying pathogenesis of psychiatric disorders and information of cognitive remediation interventions. This review synthesizes existing neuroimaging studies to examine domains of cognitive impairment, particularly processing speed, memory, attention, and executive function in SZ and MDD patients. First, white matter (WM) abnormalities are observed in processing speed deficits in both SZ and MDD, with distinct neuroimaging findings highlighting WM connectivity abnormalities in SZ and WM hyperintensity caused by small vessel disease in MDD. Additionally, the abnormal functions of prefrontal cortex and medial temporal lobe are found in both SZ and MDD patients during various memory tasks, while aberrant amygdala activity potentially contributes to a preference to negative memories in MDD. Furthermore, impaired large-scale networks including frontoparietal network, dorsal attention network, and ventral attention network are related to attention deficits, both in SZ and MDD patients. Finally, abnormal activity and volume of the dorsolateral prefrontal cortex (DLPFC) and abnormal functional connections between the DLPFC and the cerebellum are associated with executive dysfunction in both SZ and MDD. Despite these insights, longitudinal neuroimaging studies are lacking, impeding a comprehensive understanding of cognitive changes and the development of early intervention strategies for SZ and MDD. Addressing this gap is critical for advancing our knowledge and improving patient prognosis.
认知功能障碍是精神分裂症(SZ)和重度抑郁症(MDD)的关键症状之一,不仅存在于疾病发作期间,还存在于发病之前,甚至在精神症状缓解之后。随着神经影像学技术的发展,这些非侵入性方法为精神疾病的潜在发病机制以及认知修复干预措施的信息提供了有价值的见解。本综述综合了现有的神经影像学研究,以检查认知障碍的领域,特别是SZ和MDD患者的处理速度、记忆、注意力和执行功能。首先,在SZ和MDD的处理速度缺陷中均观察到白质(WM)异常,不同的神经影像学发现突出了SZ中的WM连接异常以及MDD中小血管疾病导致的WM高信号。此外,在各种记忆任务中,SZ和MDD患者的前额叶皮质和内侧颞叶功能均存在异常,而杏仁核活动异常可能导致MDD患者对负面记忆的偏好。此外,包括额顶叶网络、背侧注意力网络和腹侧注意力网络在内的大规模网络受损与SZ和MDD患者的注意力缺陷有关。最后,背外侧前额叶皮质(DLPFC)的活动和体积异常以及DLPFC与小脑之间的功能连接异常与SZ和MDD的执行功能障碍均相关。尽管有这些见解,但缺乏纵向神经影像学研究,这阻碍了对SZ和MDD认知变化的全面理解以及早期干预策略的制定。填补这一空白对于增进我们的知识和改善患者预后至关重要。