Yang Dan-Ting, Ji Ping, Sun Jiao-Jiao, Gan Yan-Sha, Guo Shuai-Yi, Zhou Zhen-He, Gao Xue-Zheng
Department of Geriatric Psychiatry, The Affiliated Mental Health Center of Nanjing Medical University, Wuxi 214151, Jiangsu Province, China.
Department of Geriatric Psychiatry, The Affiliated Mental Health Center of Jiangnan University, Wuxi 214151, Jiangsu Province, China.
World J Psychiatry. 2025 Mar 19;15(3):101494. doi: 10.5498/wjp.v15.i3.101494.
Very late-onset schizophrenia-like psychosis (VLOSLP) is a subtype of schizophrenia spectrum disorders in which individuals experience psychotic symptoms for the first time after the age of 60. The incidence of VLOSLP shows a linear relationship with increasing age. However, no studies have reported alterations in spontaneous brain activity among VLOSLP patients and their correlation with cognitive function and clinical symptoms.
To explore VLOSLP brain activity and correlations with cognitive function and clinical symptoms using resting-state functional magnetic resonance imaging.
This study included 33 VLOSLP patients and 34 healthy controls. The cognitive assessment utilized the Mini Mental State Examination, Montreal Cognitive Assessment, and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Clinical characteristic acquisition was performed the Positive and Negative Syndrome Scale (PANSS). All participants were scanned resting-state functional magnetic resonance imaging, and the data were processed using amplitude of low-frequency fluctuations (ALFF), fractional ALFF (fALFF), regional homogeneity, and voxel-mirrored homotopic connectivity (VMHC).
The VLOSLP group presented decreased ALFF values in the left cuneus, right precuneus, right precentral gyrus, and left paracentral lobule; increased fALFF values in the left caudate nucleus; decreased fALFF values in the right calcarine fissure and surrounding cortex (CAL) and right precuneus; increased regional homogeneity values in the right putamen; and decreased VMHC values in the bilateral CAL, bilateral superior temporal gyrus, and bilateral cuneus. In the VLOSLP group, ALFF values in the right precuneus were negatively correlated with Mini Mental State Examination score and PANSS positive subscale score, and VMHC values in the bilateral CAL were negatively correlated with the RBANS total score, RBANS delayed memory score, and PANSS positive subscale score.
The changes of brain activity in VLOSLP are concentrated in the right precuneus and bilateral CAL regions, which may be associated with cognitive impairment and clinically positive symptoms.
极晚发性精神分裂症样精神病(VLOSLP)是精神分裂症谱系障碍的一种亚型,患者在60岁之后首次出现精神病性症状。VLOSLP的发病率与年龄增长呈线性关系。然而,尚无研究报道VLOSLP患者的自发脑活动变化及其与认知功能和临床症状的相关性。
使用静息态功能磁共振成像探索VLOSLP患者的脑活动及其与认知功能和临床症状的相关性。
本研究纳入了33例VLOSLP患者和34名健康对照。认知评估采用简易精神状态检查表、蒙特利尔认知评估量表以及可重复性神经心理状态量表(RBANS)。使用阳性和阴性症状量表(PANSS)获取临床特征。所有参与者均接受静息态功能磁共振成像扫描,并使用低频振幅(ALFF)、分数低频振幅(fALFF)、局部一致性和体素镜像同伦连接性(VMHC)对数据进行处理。
VLOSLP组在左侧楔叶、右侧楔前叶、右侧中央前回和左侧中央旁小叶的ALFF值降低;左侧尾状核的fALFF值升高;右侧距状裂及其周围皮质(CAL)和右侧楔前叶的fALFF值降低;右侧壳核的局部一致性值升高;双侧CAL、双侧颞上回和双侧楔叶的VMHC值降低。在VLOSLP组中,右侧楔前叶的ALFF值与简易精神状态检查表得分和PANSS阳性分量表得分呈负相关,双侧CAL的VMHC值与RBANS总分、RBANS延迟记忆得分和PANSS阳性分量表得分呈负相关。
VLOSLP患者的脑活动变化集中在右侧楔前叶和双侧CAL区域,这可能与认知障碍和临床阳性症状有关。