Meta-analysis of 41 functional neuroimaging studies of executive function in schizophrenia.
Meta-analysis of 41 functional neuroimaging studies of executive function in schizophrenia.
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DOI：
10.1001/archgenpsychiatry.2009.91
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发表时间：
2009-08
影响因子：
--
通讯作者：
Glahn, David C.
中科院分区：
文献类型：
--
作者：
Minzenberg, Michael J.;Laird, Angela R.;Thelen, Sarah;Carter, Cameron S.;Glahn, David C.
前额皮质功能障碍常被报道为精神分裂症患者。目前尚不清楚这是否代表了几个前额叶区域和过程特异性损伤的巧合，还是高级认知控制网络中更单一的功能障碍。这些损伤是否被正确地认为是反映了额叶功能低下和额叶功能亢进，仍然没有解决。测试认知控制网络的共同节点是否在精神分裂症执行认知的功能性神经影像学研究中表现出改变的活动，并评估这些影响的方向。PubMed数据库。收录了41篇2007年2月之前发表的同行评议的英文文章。所有的报告都使用功能性神经成像来观察成年精神分裂症患者的执行功能表现，并报道了标准立体定向空间的全脑分析。任务主要包括延迟匹配样本、N-back、AX-CPT和Stroop任务。激活似然估计模型在meta分析中将激活最大值作为三维高斯函数的中心，并对多个比较进行统计阈值和校正。在组内分析中，健康对照组和患者激活了类似分布的皮层-皮层下网络，主要包括背外侧前额叶皮层（PFC）、腹外侧前额叶皮层、前扣带皮层（ACC）和丘脑。在组间分析中，患者显示左背外侧PFC、吻侧/背侧ACC、左丘脑（这些区域显著共存）和下/后皮层区域的激活减少。在几个中线皮层区域观察到增加的激活。小组内的激活程度因任务的不同而略有不同。健康成人和精神分裂症患者在执行任务时激活了一个质量相似的神经网络，与通用认知控制网络的参与一致，关键节点位于PFC和ACC背外侧。然而，精神分裂症患者表现出活动改变，并伴有丘脑背外侧PFC、ACC和中背侧核的缺陷。其他PFC区域的活动明显增加，这可能是补偿性的。
Prefrontal cortical dysfunction is frequently reported in schizophrenia. It remains unclear whether this represents the coincidence of several prefrontal region- and process-specific impairments or a more unitary dysfunction in a superordinate cognitive control network. Whether these impairments are properly considered reflective of hypofrontality vs hyperfrontality remains unresolved. To test whether common nodes of the cognitive control network exhibit altered activity across functional neuroimaging studies of executive cognition in schizophrenia and to evaluate the direction of these effects. PubMed database. Forty-one English-language, peer-reviewed articles published prior to February 2007 were included. All reports used functional neuroimaging during executive function performance by adult patients with schizophrenia and reported whole-brain analyses in standard stereotactic space. Tasks primarily included the delayed match-to-sample, N-back, AX-CPT, and Stroop tasks. Activation likelihood estimation modeling reported activation maxima as the center of a 3-dimensional gaussian function in the meta-analysis, with statistical thresholding and correction for multiple comparisons. In within-group analyses, healthy controls and patients activated a similarly distributed cortical-subcortical network, prominently including the dorsolateral prefrontal cortex (PFC), ventrolateral PFC, anterior cingulate cortex (ACC), and thalamus. In between-group analyses, patients showed reduced activation in the left dorsolateral PFC, rostral/dorsal ACC, left thalamus (with significant co-occurrence of these areas), and inferior/ posterior cortical areas. Increased activation was observed in several midline cortical areas. Activation within groups varied modestly by task. Healthy adults and schizophrenic patients activate a qualitatively similar neural network during executive task performance, consistent with the engagement of a general-purpose cognitive control network, with critical nodes in the dorsolateral PFC and ACC. Nevertheless, patients with schizophrenia show altered activity with deficits in the dorsolateral PFC, ACC, and mediodorsal nucleus of the thalamus. Increases in activity are evident in other PFC areas, which could be compensatory in nature.
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