Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China.
Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China.
J Psychiatr Res. 2024 Sep;177:109-117. doi: 10.1016/j.jpsychires.2024.07.006. Epub 2024 Jul 4.
Schizophrenia is a severe psychiatric disorder, characterized by positive symptoms, negative symptoms, and cognitive deficits. Elucidating the mechanism of negative symptom and cognitive deficits could contribute to the treatment and prognosis of schizophrenia. We hypothesized that abnormal functional connectivity would be involved in the indirect effects of negative symptoms on cognitive function.
A total of 150 schizophrenia male patients and 108 healthy controls matched for age, education and gender were enrolled in the study. The scores of Brief Negative Symptom Scale were divided into two factors: motivation and pleasure deficits (MAP) and diminished expression (EXP). Subsequently, a series of classic neurocognitive tests were used to evaluate cognitive functions. Resting-state fMRI data was collected from all participants. The Anatomical Automatic Labeling template was employed to establish regions of interest, thereby constructing the functional connectivity network across the entire brain. Eventually, scores of patients' negative symptoms scale, cognitive function, and strengths of abnormal functional connectivity were incorporated into a structural equation model to explore the interactions among variables.
MAP exhibited a distinctly and significantly negative impact on cognitive function. The functional connectivity between the left insula and left precuneus, along with that between the left precuneus and right angular gyrus, collectively served as intermediaries, contributing to the indirect effects of MAP and EXP on cognitive function.
Our findings demonstrated the moderating role of aberrant brain functional connectivity between negative symptoms and cognitive function, providing clues about the neural correlates of negative symptoms and cognitive deficits in schizophrenia.
精神分裂症是一种严重的精神疾病，其特征为阳性症状、阴性症状和认知缺陷。阐明阴性症状和认知缺陷的机制可能有助于精神分裂症的治疗和预后。我们假设异常的功能连接可能参与了阴性症状对认知功能的间接影响。
共纳入 150 名男性精神分裂症患者和 108 名年龄、教育和性别相匹配的健康对照者。将Brief 阴性症状量表的评分分为两个因素：动机和快感缺失（MAP）和表达减少（EXP）。随后，采用一系列经典神经认知测试来评估认知功能。所有参与者均采集静息态 fMRI 数据。采用解剖学自动标记模板建立全脑的感兴趣区，从而构建整个大脑的功能连接网络。最终，将患者的阴性症状量表评分、认知功能评分以及异常功能连接的强度纳入结构方程模型，以探讨变量之间的相互作用。
MAP 对认知功能有明显的负向影响。左侧脑岛和左侧楔前叶之间以及左侧楔前叶和右侧角回之间的功能连接作为中介，共同促成了 MAP 和 EXP 对认知功能的间接影响。
我们的研究结果表明，异常脑功能连接在阴性症状和认知功能之间具有调节作用，为精神分裂症阴性症状和认知缺陷的神经相关提供了线索。
