White Matter Integrity and Cognitive Impairment in First-Episode Psychosis
White Matter Integrity and Cognitive Impairment in First-Episode Psychosis
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DOI：
10.1176/appi.ajp.2009.09050716
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发表时间：
2010-04-01
影响因子：
17.7
通讯作者：
Crespo-Facorro, Benedicto
中科院分区：
文献类型：
--
作者：
Perez-Iglesias, Rocio;Tordesillas-Gutierrez, Diana;Crespo-Facorro, Benedicto
目的：认知功能受损是精神分裂症的核心特征。然而，很大一部分患者没有表现出任何认知缺陷。本研究的目的是评估是否有差异，在白色物质的完整性与患者之间的认知impairment.Method：扩散张量成像研究和神经认知评估进行了49例首发精神病和41例健康对照组。受试者采用连续操作测试、凹槽钉板测试、雷伊听觉言语学习测试和连线测试B部分进行评估。对于每项测试，患者样本根据表现进行细分，那些得分低于标准平均值一个标准差以上的患者被归类为受损。对于每个认知领域，使用基于体素的分析比较缺陷和非缺陷亚组中的白色物质分数各向异性。一个非参数统计方法，控制多重comparation.Results：损害的线索，使测试部分B与减少分数各向异性的右/左前丘脑辐射和下额枕束，钳小，左上级和下纵束。表现出沟槽钉板测试损伤的患者在镊子小束、额枕下束、丘脑前辐射、皮质脊髓束和皮质桥脑束中表现出各向异性分数降低。Rey听觉言语学习测试和连续性能测试的性能受损与分数anisotropic.Conclusions的显着差异：缺陷的执行和运动功能的患者与首发精神病与减少白色物质的完整性，连接额叶和颞叶皮质的主要纤维束，以及在连接皮质和皮质下区域的途径。在最低限度用药的患者中，在发病时出现这些症状，表明这些发现不能归因于慢性病或其治疗的影响。
Objective: Impaired cognitive function has been identified as a core feature of schizophrenia. However, a significant proportion of patients do not show any cognitive deficits. The aim of this study was to assess if there were differences in white matter integrity between patients with and without cognitive impairment.Method: A diffusion tensor imaging study and neurocognitive assessment were conducted in 49 patients with first-episode psychosis and 41 healthy comparison subjects. Subjects were assessed using the Continuous Performance Test, the Grooved Pegboard Test, the Rey Auditory Verbal Learning Test, and the Trail Making Test Part B. For each test, the patient sample was subdivided according to performance, with those scoring more than one standard deviation below the normative mean categorized as impaired. For each cognitive domain, white matter fractional anisotropy in deficit and non-deficit subgroups was compared using a voxel-based analysis. A nonparametric statistical method, controlling for multiple comparisons, was applied.Results: Impairment on the Trail Making Test Part B was associated with reduced fractional anisotropy in the right/left anterior thalamic radiation and inferior fronto-occipital fasciculus, forceps minor, and left superior and inferior longitudinal fasciculi. Patients exhibiting Grooved Pegboard Test impairment showed reduced fractional anisotropy in the forceps minor, inferior fronto-occipital fasciculus, anterior thalamic radiation, and corticospinal and corticopontine tracts. Impaired performance on the Rey Auditory Verbal Learning Test and Continuous Performance Test was not associated with significant differences in fractional anisotropy.Conclusions: Deficits in executive and motor functioning in patients with first-episode psychosis are associated with reductions in white matter integrity in the major fasciculi that connect the frontal and temporal cortices as well as in pathways connecting cortical and subcortical regions. Their presence at the onset of illness, in minimally medicated patients, indicates that these findings are not attributable to effects of chronic illness or its treatment.