Ou Yangpan, Chen Zhaobin, Wang Ying, Li Huabing, Liu Feng, Li Ping, Lv Dongsheng, Liu Yong, Lang Bing, Zhao Jingping, Guo Wenbin
Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
Department of Mental Health Center of Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
BMC Psychiatry. 2025 Mar 31;25(1):308. doi: 10.1186/s12888-025-06747-x.
Clinical high-risk (CHR) refers to prodromal phase before schizophrenia onset, characterized by attenuated psychotic symptoms and functional decline. They exhibit similar but milder cognitive impairments, brain abnormalities and eye movement change compared with first-episode schizophrenia (FSZ). These alterations may increase vulnerability to transitioning to the disease. This study explores cognitive-related functional connectivity (FC) and eye movement abnormalities to examine differences in the progression of schizophrenia.
Thirty drug-naive FSZ, 28 CHR, and 30 healthy controls (HCs) were recruited to undergo resting-state functional magnetic resonance imaging (rs-fMRI). Connectome-based predictive modeling (CPM) was employed to extract cognitive-related brain regions, which were then selected as seeds to form FC networks. Support vector machine (SVM) was used to distinguish FSZ from CHR. Smooth pursuit eye-tracking tasks were conducted to assess eye movement features.
FSZ displayed decreased cognitive-related FC between right posterior cingulate cortex and right superior frontal gyrus compared with HCs and between right amygdala and left inferior parietal gyrus (IPG) compared with CHR. SVM analysis indicated a combination of BACS-SC and CFT-A scores, and FC between right amygdala and left IPG could serve as a potential biomarker for distinguishing FSZ from CHR with high sensitivity. FSZ also exhibited a wide range of eye movement abnormalities compared with HCs, which were associated with alterations in cognitive-related FC.
FSZ and CHR exhibited different patterns of cognitive-related FC and eye movement alteration. Our findings illustrate potential neuroimaging and cognitive markers for early identification of psychosis that could help in the intervention of schizophrenia in high-risk groups.
临床高危（CHR）指精神分裂症发病前的前驱期，其特征为精神病性症状减弱和功能衰退。与首发精神分裂症（FSZ）相比，他们表现出相似但更轻微的认知障碍、脑结构异常和眼动变化。这些改变可能会增加发展为该病的易感性。本研究探讨认知相关功能连接（FC）和眼动异常，以检验精神分裂症进展中的差异。
招募30例未用药的FSZ患者、28例CHR患者和30名健康对照（HC）进行静息态功能磁共振成像（rs-fMRI）。采用基于连接组的预测模型（CPM）提取认知相关脑区，然后将其选作种子以形成FC网络。使用支持向量机（SVM）区分FSZ和CHR。进行平稳跟踪眼动任务以评估眼动特征。
与HC相比，FSZ患者右侧后扣带回皮质与右侧额上回之间以及与CHR相比，右侧杏仁核与左侧顶下小叶（IPG）之间的认知相关FC降低。SVM分析表明，BACS-SC和CFT-A评分的组合以及右侧杏仁核与左侧IPG之间的FC可作为高敏感性区分FSZ和CHR的潜在生物标志物。与HC相比，FSZ还表现出广泛的眼动异常，这与认知相关FC的改变有关。
FSZ和CHR表现出不同模式的认知相关FC和眼动改变。我们的研究结果说明了潜在的神经影像学和认知标志物，用于早期识别精神病，这有助于对高危人群的精神分裂症进行干预。
