Association of Cerebral Deficits With Clinical Symptoms in Antipsychotic-Naive First-Episode Schizophrenia: An Optimized Voxel-Based Morphometry and Resting State Functional Connectivity Study
Association of Cerebral Deficits With Clinical Symptoms in Antipsychotic-Naive First-Episode Schizophrenia: An Optimized Voxel-Based Morphometry and Resting State Functional Connectivity Study
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未接受抗精神病药物治疗的首发精神分裂症中脑缺陷与临床症状的关联：基于体素的优化形态测量和静息态功能连接研究
DOI：
10.1176/appi.ajp.2008.08020183
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发表时间：
2009-02-01
影响因子：
17.7
通讯作者：
Gong, Qiyong
中科院分区：
文献类型：
--
作者：
Lui, Su;Deng, Wei;Gong, Qiyong
目的：本研究的目的是描述临床症状和解剖和功能性脑功能缺损之间的关联在一个相对较大的样本抗精神病药初治首发精神分裂症患者使用优化的基于体素的形态测量和静息状态功能连接analysis.Method：参与者是68抗精神病药初治首发精神分裂症患者和68匹配的健康对照组。患者和健康对照受试者均使用体积三维扰相梯度回忆序列和梯度回波回波平面回波成像序列进行扫描。采用阳性和阴性症状量表（PANSS）对首发精神分裂症患者进行精神病理学评估。优化的基于体素的形态测量学被用来表征精神分裂症患者的灰质缺陷。区域体积减少的临床意义进行了研究，通过检查其与首发精神分裂症患者的症状和静息状态功能连接的改变时，灰质体积减少的脑区被用作种子区。精神分裂症患者右侧上级颞回灰质体积明显减少（布罗德曼区41）、右颞中回（布罗德曼区21）和右前扣带回（布罗德曼区32）。如阳性症状、一般精神病理学症状、思维障碍、激活、偏执和冲动性攻击的PANSS评分以及PANSS总评分所示，这些脑区的灰质体积减少与更大的干扰相关。PANSS评分之间的思维障碍和颞壳核连接呈正相关，颞楔前叶连接和总PANSS评分以及阴性症状和anergia.Conclusions分数之间的负相关性被发现：研究结果显示，抗精神病药初治的首发精神分裂症患者的右上级颞回，右颞中回，右前扣带回的体积损失。此外，涉及右侧上级颞回和颞中回的功能网络与临床症状严重程度相关。在静息状态下与已确定的灰质缺陷区域的连接中未观察到异常。
Objective: The purpose of the present study was to characterize the association between clinical symptoms and anatomical and functional cerebral deficits in a relatively large sample of antipsychotic-naive first-episode schizophrenia patients using optimized voxel-based morphometry and resting state functional connectivity analysis.Method: Participants were 68 antipsychotic-naive first-episode schizophrenia patients and 68 matched healthy comparison subjects. Both patients and healthy comparison subjects were scanned using a volumetric three-dimensional spoiled gradient recall sequence and a gradient-echo echo-planar imaging sequence. Psychopathology of first-episode schizophrenia patients was evaluated using the Positive and Negative Syndrome Scale (PANSS). Optimized voxel-based morphometry was used to characterize gray matter deficits in schizophrenia patients. The clinical significance of regional volume reduction was investigated by examining its association with symptoms in patients with first-episode schizophrenia and with alterations in resting state functional connectivity when brain regions with gray matter volume reduction were used as seed areas.Results: Significantly decreased gray matter volume was observed in schizophrenia patients in the right superior temporal gyrus (Brodmann's area 41), right middle temporal gyrus (Brodmann's area 21), and right anterior cingulate gyrus (Brodmann's area 32). Decreased gray matter volume in these brain regions was related to greater disturbance as shown on PANSS scores for positive symptoms, general psychopathology symptoms, thought disturbance, activation, paranoia, and impulsive aggression as well as total PANSS scores. A positive correlation was observed between PANSS scores for thought disturbance and temporo-putamen connectivity, and negative correlations were found between temporo-precuneus connectivity and total PANSS scores as well as scores for negative symptoms and anergia.Conclusions: The findings revealed volume loss in the right superior temporal gyrus, right middle temporal gyrus, and right anterior cingulate gyrus among antipsychotic-naive first-episode schizophrenia patients. In addition, the functional networks involving the right superior temporal gyrus and middle temporal gyrus were associated with clinical symptom severity. No abnormalities were observed in resting state connectivity with regions of identified gray matter deficits.