Neurocognitive deficits and prefrontal cortical atrophy in patients with schizophrenia
Neurocognitive deficits and prefrontal cortical atrophy in patients with schizophrenia
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DOI：
10.1016/j.schres.2007.11.023
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发表时间：
2008-04-01
影响因子：
4.5
通讯作者：
Nahas, Ziad
中科院分区：
文献类型：
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作者：
Bonilha, Leonardo;Molnar, Chris;Nahas, Ziad
理由：认知缺陷在精神分裂症中特别重要，因为它们与不良预后密切相关。我们调查了前额叶皮质萎缩之间的关系，通过MRI和神经心理学表现的参与者诊断为DSM-IV-TR schizophrenia.Methods：14个未服药的成年患者和13个匹配的对照进行了研究。受试者接受MRI，得到1 mm各向同性T1加权图像。使用SPM 5将基于体素的形态测量应用于所有图像。Brodmann区（BA）9的平均灰度值也被提取和评估使用简单回归沿着相对得分差异对患者的神经心理测试comparedons.Results：患者表现出较差的性能控制词联想任务（COWAT），威斯康星州卡片分类测验（WCST）和连线测验（TMT）。根据冷漠评价量表（AES），患者的冷漠程度也更高。精神分裂症患者左侧辅助运动区、双侧额上级回、左侧额中回、右侧盖区、左侧角回、左侧上级颞回、左侧小脑半球灰质体积明显减少。在精神分裂症组中，BA 9灰质体积减少与WCST和TMT-B的表现较差相关。结论：精神分裂症患者的前额叶灰质异常可能与一些症状有关，包括设置转换困难和心理灵活性下降。进一步的研究评估前额叶的连接可能会澄清，如果这种损害的结果，从异常的额区单独，或改变网络涉及额区和额外区的结果。(C)2007 Elsevier B. V.保留所有权利。
Rationale: Cognitive deficits are of particular importance in schizophrenia since they are strongly associated with poor prognosis. We investigated the relationship between prefrontal cortical atrophy as measured by MRI and the neuropsychological performance of participants diagnosed with DSM-IV-TR schizophrenia.Methods: Fourteen unmedicated adult patients and thirteen matched controls were studied. Subjects underwent MRI yielding I mm isotropic T1-weighted images. Voxel based morphometry was applied to all images using SPM5. The mean gray level of Brodmann area (BA) 9 was also extracted and evaluated using simple regression along with relative score differences on patients neuropsychological tests compared to controls.Results: Patients exhibited a poorer performance on the Controlled Word Association Task (COWAT), Wisconsin Card Sorting Test (WCST) and Trail Making Test (TMT). Patients also presented a greater level of apathy as indexed by the Apathy Evaluation Scale (AES). There was a significant decrease in gray matter volume in patients with schizophrenia in left supplementary motor area, bilateral superior frontal gyrus, left middle frontal gyrus, right opercular area, left angular gyrus, left superior temporal gyrus and left cerebellar hemisphere. Within the schizophrenia group, decreased BA9 gray matter volume was correlated with poorer performance on the WCST and TMT-B.Conclusion: Prefrontal gray matter abnormalities in schizophrenia patients may be associated with some symptoms including difficulties with set-shifting and decreased mental flexibility. Further studies evaluating prefrontal connectivity may clarify if such impairment results from abnormalities of the frontal area alone, or are a result of altered networks involving the frontal and extra-frontal areas. (C) 2007 Elsevier B.V. All rights reserved.