Kristensen Tina D, Ambrosen Karen S, Raghava Jayachandra M, Syeda Warda T, Dhollander Thijs, Lemvigh Cecilie K, Bojesen Kirsten B, Barber Anita D, Nielsen Mette Ø, Rostrup Egill, Pantelis Christos, Fagerlund Birgitte, Glenthøj Birte Y, Ebdrup Bjørn H
Center for Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, Copenhagen University Hospital, Glostrup, Denmark.
Functional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Glostrup, Denmark.
Schizophrenia (Heidelb). 2024 Aug 31;10(1):72. doi: 10.1038/s41537-024-00487-9.
Patients with schizophrenia exhibit structural and functional dysconnectivity but the relationship to the well-documented cognitive impairments is less clear. This study investigates associations between structural and functional connectivity and executive functions in antipsychotic-naïve patients experiencing schizophrenia. Sixty-four patients with schizophrenia and 95 matched controls underwent cognitive testing, diffusion weighted imaging and resting state functional magnetic resonance imaging. In the primary analyses, groupwise interactions between structural connectivity as measured by fixel-based analyses and executive functions were investigated using multivariate linear regression analyses. For significant structural connections, secondary analyses examined whether functional connectivity and associations with executive functions also differed for the two groups. In group comparisons, patients exhibited cognitive impairments across all executive functions compared to controls (p < 0.001), but no group difference were observed in the fixel-based measures. Primary analyses revealed a groupwise interaction between planning abilities and fixel-based measures in the left anterior thalamic radiation (p = 0.004), as well as interactions between cognitive flexibility and fixel-based measures in the isthmus of corpus callosum and cingulum (p = 0.049). Secondary analyses revealed increased functional connectivity between grey matter regions connected by the left anterior thalamic radiation (left thalamus with pars opercularis p = 0.018, and pars orbitalis p = 0.003) in patients compared to controls. Moreover, a groupwise interaction was observed between cognitive flexibility and functional connectivity between contralateral regions connected by the isthmus (precuneus p = 0.028, postcentral p = 0.012), all p-values corrected for multiple comparisons. We conclude that structural and functional connectivity appear to associate with executive functions differently in antipsychotic-naïve patients with schizophrenia compared to controls.
精神分裂症患者存在结构和功能连接障碍，但其与已被充分记录的认知障碍之间的关系尚不清楚。本研究调查了初发精神分裂症患者结构和功能连接与执行功能之间的关联。64例精神分裂症患者和95例匹配的对照者接受了认知测试、弥散加权成像和静息态功能磁共振成像。在主要分析中，使用多元线性回归分析研究基于固定点分析测量的结构连接与执行功能之间的组间交互作用。对于显著的结构连接，次要分析检查两组在功能连接以及与执行功能的关联方面是否也存在差异。在组间比较中，与对照组相比，患者在所有执行功能方面均表现出认知障碍（p < 0.001），但基于固定点的测量未观察到组间差异。主要分析显示，左侧丘脑前辐射中计划能力与基于固定点的测量之间存在组间交互作用（p = 0.004），以及胼胝体峡部和扣带束中认知灵活性与基于固定点的测量之间存在交互作用（p = 0.049）。次要分析显示，与对照组相比，患者左侧丘脑前辐射连接的灰质区域之间的功能连接增加（左侧丘脑与岛盖部p = 0.018，眶部p = 0.003）。此外，在胼胝体峡部连接的对侧区域之间的认知灵活性与功能连接之间观察到组间交互作用（楔前叶p = 0.028，中央后回p = 0.012），所有p值均针对多重比较进行了校正。我们得出结论，与对照组相比，初发精神分裂症患者的结构和功能连接与执行功能的关联似乎有所不同。
