Aberrant intrinsic brain activity and cognitive deficit in first-episode treatment-naive patients with schizophrenia
Aberrant intrinsic brain activity and cognitive deficit in first-episode treatment-naive patients with schizophrenia
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首次接受治疗的精神分裂症患者异常的内在大脑活动和认知缺陷
DOI：
10.1017/s0033291712001638
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发表时间：
2013-04-01
影响因子：
6.9
通讯作者：
Li, T.
中科院分区：
文献类型：
--
作者：
He, Z.;Deng, W.;Li, T.
背景。鉴于默认模式网络（DMN）在认知功能中的重要作用以及精神分裂症中众所周知的神经认知缺陷，系统地研究精神分裂症患者的神经认知功能障碍与DMN的异常内在活动以及功能连接之间的关系是很有趣的。
方法。首次发作、未接受治疗的精神分裂症患者（FES）（n = 115）和健康对照者（n = 113）接受静息态功能磁共振成像（fMRI）扫描和神经认知测试。使用低频波动振幅（fALFF）评估内在神经活动，并通过基于种子的相关性分析评估静息态功能连接，然后在患者和对照者之间进行比较。接着将患者的异常内在活动和DMN连接与神经认知表现和临床症状相关联。
结果。与对照者相比，FES患者在双侧内侧前额叶皮质（MPFC）和眶额叶皮质（OFC）中显示fALFF降低，在双侧壳核中fALFF升高。在FES患者的左侧脑岛和双侧背外侧前额叶皮质（DLPFC）中观察到与DMN的功能连接增加。在患者中，双侧OFC的异常fALFF与认知加工速度相关；左侧OFC和右侧壳核的fALFF与兴奋/激活和瓦解的临床因素相关；左侧脑岛中增加的DMN功能连接与阳性、兴奋/激活、瓦解的临床因素以及持续注意领域的神经认知缺陷相关。
结论。精神分裂症患者的神经认知功能障碍与DMN的异常内在活动以及功能连接之间的这些关联可能为该疾病的神经机制提供重要的见解。
Background Given the important role of the default mode network (DMN) in cognitive function and the well-known neurocognitive deficit in schizophrenia, it is intriguing to examine systematically the relationship between neurocognitive dysfunction and aberrant intrinsic activities, and also functional connectivity, of the DMN in patients with schizophrenia. Method First-episode, treatment-naive patients with schizophrenia (FES) (n = 115) and healthy controls (n = 113) underwent resting-state functional magnetic resonance imaging (fMRI) scans and neurocognitive tests. Intrinsic neural activities evaluated by using the fragment amplitude of low-frequency fluctuations (fALFF) and the resting-state functional connectivity assessed by seed-based correlational analysis were compared between patients and controls. Aberrant intrinsic activities and DMN connectivity in patients were then correlated to neurocognitive performance and clinical symptoms. Results Compared to controls, patients with FES showed decreased fALFF in the bilateral medial prefrontal cortex (MPFC) and the orbitofrontal cortex (OFC), and increased fALFF in the bilateral putamen. Increased functional connectivity with the DMN was observed in the left insula and bilateral dorsolateral PFC (DLPFC) in patients with FES. In patients, aberrant fALFF in the bilateral OFC were correlated with cognitive processing speed; fALFF in the left OFC and right putamen were correlated with the clinical factors excited/activation and disorganization; and increased DMN functional connectivity in the left insula was correlated with the clinical factors positive, excited/activation, disorganization and neurocognitive deficit in the domain of sustained attention. Conclusions These associations between neurocognitive dysfunction and aberrant intrinsic activities, and also functional connectivity, of the DMN in patients with schizophrenia may provide important insights into the neural mechanism of the disease.