fMRI Study on the Common Abnormal Neural Circuitry in Schizophrenia and Epileptic Psychosis

据报道，异常的自主眼球运动是精神分裂症的遗传易损性标志。我们研究了在执行各种眼动任务时的大脑激活模式，以利用功能磁共振来阐明精神分裂症的异常神经回路。我们还对症状与精神分裂症相似的癫痫精神病患者进行了调查，以弄清相同的神经回路是否受到影响。这项研究得到了日本大学医学院伦理委员会的批准。在完全解释了实验过程后，所有参与者都获得了书面知情同意。正常对照组21例(男11例，女10例，平均年龄39.2±10.2岁)，精神分裂症18例(12/6，34.8±8.5岁)，癫痫精神病5例(5/0，34.8±14.4岁)。使用1.5Tesla临床磁共振扫描仪，用梯度回忆法获取脑成像数据，以获得BO…覆盖全脑的LD对比度更高(TR4000ms，TE 62ms，像素大小3.0×3.0 mm，层数40层，视野192 mm，矩阵×，翻转角90°，层厚3 mm)。使用眼动仪进行任务显示和眼动监测。每个受试者在40秒的四个眼动任务(眼跳、反眼跳、顺畅追逐眼球运动、带有注意力增强的SPEM任务)和40秒的基线(注视)之间交替进行五个系列的实验。图像分析采用SPM99，对未矫正P&t；0.001和簇水平校正P&lt；0.05进行显著水平的随机效应分析。与正常对照组相比，精神分裂症和癫痫精神病患者在视觉引导眼跳任务中额叶功能低下或效率低下，在抗眼跳任务中发现纹状丘脑低激活。因此，这些发现可能与精神状态有关。而在注意增强平滑追踪眼动任务中，右脑激活不足仅见于精神分裂症患者。目前的结果与精神分裂症患者异常半球偏侧的证据是一致的，最近使用各种语言任务的fMRI研究报告了这一证据。较少

The abnormal voluntary eye movements are reported to be a genetic vulnerability marker for schizophrenia. We have studied brain activation patterns during performing various eye movement tasks to elucidate abnormal neural circuitry for schizophrenia using functional MRI. We have also investigated the patients with epileptic psychosis, whose symptoms are similar to those with schizophrenia, to clarify whether the same neural circuit is affected or not. This research obtained the approval from the ethical committee of Nihon University School of Medicine. Written informed consent was obtained from all the participants after the procedure of the experiments was fully explained. The subjects were 21 normal controls (11 males/ 10 females, mean age 39.2±10.2 yrs), 18 patients with schizophrenia (12/ 6, 34.8±8.5 yrs), and five patients with epileptic psychosis (5/ 0, 34.8±14.4 yrs). Using a 1.5 Tesla clinical MRI scanner, brain imaging data were acquired with gradient-recalled EPI to obtain BO … More LD contrast encompassing the entire brain (TR 4000ms, TE 62ms, pixel size 3.0×3.0 mm, number of slices 40, FOV 192 mm, matrix 64×64, flip angle 90 deg, slice thickness 3 mm). An eye tracking instrument was used for task display and eye movement monitoring. Each subject performed five series alternating between 40 sec of four eye movement task (saccade, anti-saccade, smooth pursuit eye movement, SPEM task with attention enhancement procedure) and 40 sec of baseline (fixation). Image analysis was performed using SPM99with random-effect analysis at a significant level of uncorrected p<0.001 and cluster level corrected p<0.05.Compared with normal controls, low capacity or inefficiency in frontal function during visually-guided saccade task and striate-thalamic hypo-activation during anti-saccade task was found both in schizophrenia and epileptic psychosis. Therefore, these findings may be attributable to psychotic state. On the other hand, right hemisphere hypo-activation during smooth pursuit eye movement task with attention enhanced procedure was found only in schizophrenia. The present results are in accordance with the evidence for abnormal hemispherical laterality in schizophrenia, that have been reported by recent fMRI studies using various language tasks. Less