Pattern of neural responses to verbal fluency shows diagnostic specificity for schizophrenia and bipolar disorder.
Pattern of neural responses to verbal fluency shows diagnostic specificity for schizophrenia and bipolar disorder.
复制标题
DOI：
10.1186/1471-244x-11-18
复制
发表时间：
2011-01-28
期刊：
影响因子：
4.4
通讯作者：
McGuire PK
中科院分区：
文献类型：
--
作者：
Costafreda SG;Fu CH;Picchioni M;Toulopoulou T;McDonald C;Kravariti E;Walshe M;Prata D;Murray RM;McGuire PK
执行功能和语言处理的损伤是精神分裂症和双相情感障碍的特征。他们的功能性神经解剖学展示了每种疾病所共有和特有的特征。确定精神分裂症和双相情感障碍的神经反应的不同模式可能为其诊断提供生物标志物。104名参与者在执行语音语言流畅性任务时接受了功能性磁共振成像（fMRI）扫描。研究对象为32例精神分裂症缓解期患者、32例双相情感障碍患者和40例健康志愿者。在每组中检查了对语言流畅性的神经反应，并使用机器学习分析评估了神经反应模式的诊断潜力。在语言流畅性任务中，与健康对照组相比，两组患者的前扣带回、左背外侧前额叶皮层和右壳核的激活增加，楔前叶和后扣带回的失活减少。精神分裂症患者的激活幅度最大，其次是双相情感障碍患者，然后是健康个体。在精神分裂症中观察到相对于双相情感障碍和健康受试者的右下额叶和右背外侧前额叶皮质的额外招募。神经反应的模式正确地识别出精神分裂症患者的准确率为92%，而双相情感障碍患者的准确率为79%，其中错误分类通常是双相受试者作为健康对照。总之，精神分裂症和双相情感障碍都与前额叶、纹状体和默认模式网络的功能改变有关，但这种功能障碍的程度在精神分裂症中特别明显。对语言流畅性的反应模式是精神分裂症的高度诊断，与双相情感障碍不同。语言处理功能MRI测量的模式分类是精神分裂症的潜在诊断标志。
Impairments in executive function and language processing are characteristic of both schizophrenia and bipolar disorder. Their functional neuroanatomy demonstrate features that are shared as well as specific to each disorder. Determining the distinct pattern of neural responses in schizophrenia and bipolar disorder may provide biomarkers for their diagnoses. 104 participants underwent functional magnetic resonance imaging (fMRI) scans while performing a phonological verbal fluency task. Subjects were 32 patients with schizophrenia in remission, 32 patients with bipolar disorder in an euthymic state, and 40 healthy volunteers. Neural responses to verbal fluency were examined in each group, and the diagnostic potential of the pattern of the neural responses was assessed with machine learning analysis. During the verbal fluency task, both patient groups showed increased activation in the anterior cingulate, left dorsolateral prefrontal cortex and right putamen as compared to healthy controls, as well as reduced deactivation of precuneus and posterior cingulate. The magnitude of activation was greatest in patients with schizophrenia, followed by patients with bipolar disorder and then healthy individuals. Additional recruitment in the right inferior frontal and right dorsolateral prefrontal cortices was observed in schizophrenia relative to both bipolar disorder and healthy subjects. The pattern of neural responses correctly identified individual patients with schizophrenia with an accuracy of 92%, and those with bipolar disorder with an accuracy of 79% in which mis-classification was typically of bipolar subjects as healthy controls. In summary, both schizophrenia and bipolar disorder are associated with altered function in prefrontal, striatal and default mode networks, but the magnitude of this dysfunction is particularly marked in schizophrenia. The pattern of response to verbal fluency is highly diagnostic for schizophrenia and distinct from bipolar disorder. Pattern classification of functional MRI measurements of language processing is a potential diagnostic marker of schizophrenia.