Triple Network Model Dynamically Revisited: Lower Salience Network State Switching in Pre-psychosis
Triple Network Model Dynamically Revisited: Lower Salience Network State Switching in Pre-psychosis
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DOI：
10.3389/fphys.2020.00066
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发表时间：
2020-02-11
影响因子：
4
通讯作者：
Van De Ville, Dimitri
中科院分区：
文献类型：
--
作者：
Bolton, Thomas A. W.;Wotruba, Diana;Van De Ville, Dimitri
新出现的证据已将默认模式、中央执行和显着性网络（DMN/CEN/SAL）之间的网络协调改变归因于精神分裂症中出现的干扰，但对高危精神病阶段知之甚少。此外，尽管对于解决转化为临床诊断的精神分裂症的可能不同先兆至关重要，但查明特定网络与网络相互作用中的损伤仍然特别具有挑战性。我们通过功能连接的动态方法解决了这一问题，通过共激活模式（CAP）分析研究了右前脑的相互作用。我们利用静息态fMRI在19名受试者患有阈下妄想和幻觉（UHR），28精神病的风险与基本症状描述只有自我经历的亚临床障碍（BS），和29名健康对照（CTR）匹配的年龄，性别，利手，和智力。我们提取了最经常出现的CAP，比较了它们的相对发生率和平均停留时间，以探索它们的时间表达，并量化了发生平衡，以评估竞争关系的假定损失。我们的研究结果证实了右前额叶在管理CEN到DMN过渡中的关键作用，在精神病发作之前出现功能障碍，特别是当第一次发生精神病症状时。在UHR受试者中，它与DMN一起更长时间地活跃，并且在SAL/DMN状态与具有由DMN失活取代的EAN/CEN激活的状态之间存在竞争损失。这些功能表明，异常的网络切换破坏了一个人的能力，以区分内部世界和外部环境，这是伴随着可识别性和过度意识到内部过程所反映的延长表达的右前岛默认模式共激活模式。
Emerging evidence has attributed altered network coordination between the default mode, central executive, and salience networks (DMN/CEN/SAL) to disturbances seen in schizophrenia, but little is known for at-risk psychosis stages. Moreover, pinpointing impairments in specific network-to-network interactions, although essential to resolve possibly distinct harbingers of conversion to clinically diagnosed schizophrenia, remains particularly challenging. We addressed this by a dynamic approach to functional connectivity, where right anterior insula brain interactions were examined through co-activation pattern (CAP) analysis. We utilized resting-state fMRI in 19 subjects suffering from subthreshold delusions and hallucinations (UHR), 28 at-risk for psychosis with basic symptoms describing only self-experienced subclinical disturbances (BS), and 29 healthy controls (CTR) matched for age, gender, handedness, and intelligence. We extracted the most recurring CAPs, compared their relative occurrence and average dwell time to probe their temporal expression, and quantified occurrence balance to assess the putative loss of competing relationships. Our findings substantiate the pivotal role of the right anterior insula in governing CEN-to-DMN transitions, which appear dysfunctional prior to the onset of psychosis, especially when first attenuated psychotic symptoms occur. In UHR subjects, it is longer active in concert with the DMN and there is a loss of competition between a SAL/DMN state, and a state with insula/CEN activation paralleled by DMN deactivation. These features suggest that abnormal network switching disrupts one's capacity to distinguish between the internal world and external environment, which is accompanied by inflexibility and an excessive awareness to internal processes reflected by prolonged expression of the right anterior insula-default mode co-activation pattern.