Resting-state functional connectivity changes within the default mode network and the salience network after antipsychotic treatment in early-phase schizophrenia.
Resting-state functional connectivity changes within the default mode network and the salience network after antipsychotic treatment in early-phase schizophrenia.
复制标题
早期精神分裂症抗精神病药物治疗后默认模式网络和显着网络内静息态功能连接的变化
DOI：
10.2147/ndt.s123598
复制
发表时间：
2017
影响因子：
3.2
通讯作者：
Liu D
中科院分区：
文献类型：
--
作者：
Wang Y;Tang W;Fan X;Zhang J;Geng D;Jiang K;Zhu D;Song Z;Xiao Z;Liu D
目的精神分裂症患者的静息状态功能连接异常，特别是默认模式网络（DMN）和突出网络（SN）异常，但抗精神病药物对这些网络的影响尚不清楚。本研究旨在探讨非典型抗精神病药物对精神分裂症患者DMN和SN的影响及其与症状改善的关系。方法对33例在上海精神卫生中心接受抗精神病药物治疗的精神分裂症患者进行前瞻性研究。招募了33名年龄和性别相匹配的健康对照。所有受试者均行功能性磁共振成像（fMRI）检查。健康对照只扫描一次；治疗前后6-8周分别进行扫描。结果DMN中，治疗后患者右侧颞上回、右侧额内侧回、左侧额上回FC增加，右侧扣带后/楔前叶FC减少（P<0.005）。SN组患者右侧小脑前叶和左侧岛叶FC减少（P<0.005）。DMN右侧后扣带/楔前叶区FC与治疗前后临床总体印象（CGI）评分差异（r= - 0.564， P=0.023）、阴性趋势、治疗前后PANSS（阳性和阴性症状量表）总分差异（r= - 0.475， P=0.063）、PANSS阳性症状评分差异（r= - 0.481， P=0.060）呈负相关。结论非典型抗精神病药物可调节早期精神分裂症患者DMN内某些关键脑区FC，可能与症状改善有关。然而，非典型抗精神病药物对SN的影响尚不清楚。
Objective Abnormal resting-state functional connectivity (FC), particularly in the default mode network (DMN) and the salience network (SN), has been reported in schizophrenia, but little is known about the effects of antipsychotics on these networks. The purpose of this study was to examine the effects of atypical antipsychotics on DMN and SN and the relationship between these effects and symptom improvement in patients with schizophrenia. Methods This was a prospective study of 33 patients diagnosed with schizophrenia and treated with antipsychotics at Shanghai Mental Health Center. Thirty-three healthy controls matched for age and gender were recruited. All subjects underwent functional magnetic resonance imaging (fMRI). Healthy controls were scanned only once; patients were scanned before and after 6–8 weeks of treatment. Results In the DMN, the patients exhibited increased FC after treatment in the right superior temporal gyrus, right medial frontal gyrus, and left superior frontal gyrus and decreased FC in the right posterior cingulate/precuneus (P<0.005). In the SN, the patients exhibited decreased FC in the right cerebellum anterior lobe and left insula (P<0.005). The FC in the right posterior cingulate/precuneus in the DMN negatively correlated with the difference between the Clinical Global Impression (CGI) score pre/post-treatment (r=−0.564, P=0.023) and negative trends with the difference in the Positive and Negative Syndrome Scale (PANSS) total score pre/post-treatment (r=−0.475, P=0.063) and the difference in PANSS-positive symptom scores (r=−0.481, P=0.060). Conclusion These findings suggest that atypical antipsychotics could regulate the FC of certain key brain regions within the DMN in early-phase schizophrenia, which might be related to symptom improvement. However, the effects of atypical antipsychotics on SN are less clear.