首发未治疗精神分裂症自发脑活动水平与认知功能关联研究

Spontaneous Brain Activity and Cognitive Function in Drug-Na?ve First-Episode Schizophrenia Patients

目的:探讨首发未治疗精神分裂症患者自发脑活动改变及其与认知功能的关系。方法:招募42例未治疗首发精神分裂症病人及38例健康对照者,进行功能磁共振扫描,采用局部一致性(regional homogeneity, ReHo)和分数低频振幅(fractional amplitude of low-frequency fluctuations, fALFF)检测受试者自发脑活动。采用阳性及阴性症状量表以及数字广度、词语流畅性、Stroop及连线测试、威斯康星卡片分类等认知测试评定患者症状及认知功能。结果:与对照组相比,患者组左侧尾状核fALFF升高(P<0.05, AlphaSim校正);右侧尾状核及双侧豆状核f ALFF值、右侧尾状核和左侧豆状核ReHo值有升高趋势(P<0.005,AlphaSim校正后P<0.1)。患者组认知测试成绩均较对照组差(P<0.001)。偏相关分析显示患者组右侧尾状核fALFF与数字广度成绩呈负相关(r=-0.530, P=0.02, Bonferroni校正);患者组左侧尾状核fALFF与词语流畅性呈正相关趋势(r=0.333,P=0.038,Bonferroni校正后P<0.1)。结论:纹状体自发脑活动异常可能是精神分裂症发病及认知损害的生物学标志之一。

Objective:To investigate the relationship between spontaneous brain activity and cognitive function in drug- naive patients with first-episode schizophrenia.Methods:We recruited 42drug-naive first-episode patients and 38age-, gender-matched healthy volunteers.Resting-state funetional magnetic resonance imaging was performed in all the participants.Spontaneous brain activity was computed by using regional homogeneity(ReHo)and fractional amplitude of low-frequency fluetuations(fALFF).The symptoms and cognitive function of all subjects were assessed by using Positive and Negative Symptom Scale,Digit Span Test,Verbal Fluency Test,Stroop Color Word Test and Trail Marking Test and Wiseonsin Card Sorting Test.Results:Compared with healthy volunteers,patients had significantly increased fALFF in the left candate nucleus(P<0.05,AlphaSim correction),trend-level increase of fALFF in fight caudate nucleus and bilateral lenticular nucleus,and trend-level increase of ReHo in fight caudate nueleus and the left lenticular nucleus(P<0.005,but P<0.1 after AlphaSim correetion).Patients performances in the five cognitive funetion tests were significantly defieient compared with healthy volunteers(P<0.001).Partial correlation analysis showed that fALFF of the fight caudate nucleus was negatively correlated with the performance of Digit Span Test in patients(r=-0.530,P=-0.02,Bonferroni eorreetion);fALFF of the left candate was positively correlated with the performance of Verbal Fluency Test in patients(r=0.333,P=-0.038;P<0.1 after BoIlferroni correction).Conclusion:This study suggests that spontaneous brain activity changes in striatum may be one of the biomarkers for schizophrenia and cognitive impairment in this disease.