不同年龄段未治疗精神分裂症灰质网络改变

Characteristics of the grey matter network in untreated schizophrenia at different ages

目的:探讨未用药情况下不同年龄段精神分裂症(SCZ)患者脑灰质网络改变的特点。方法:将150例未用药精神分裂症患者以及年龄和性别相匹配的210例健康志愿者(对照组)纳入本研究。按年龄将2组被试分别分为A1~A4共4个亚组(16~24岁、25~34岁、35~44岁、≥45岁)。所有被试在3.0T MR扫描仪上完成T1加权图像的采集,并使用FreeSurfer软件包对图像进行预处理,得到皮层厚度值;然后,以区域间皮层厚度的相关系数为连接强度,构建各个年龄组的协变网络,对网络属性进行分析,并与对照组进行比较,以确定不同年龄阶段SCZ患者脑网络异常改变的特点。结果:与对照组相比,全局属性方面,患者组出现小世界属性(P=0.049)与局部效率(P=0.033)的降低;节点属性方面,患者组各个年龄亚组出现共有网络改变的基础上,年龄较大的患者组出现了更多的网络异常,包括25岁以上患者组出现左扣带回峡部和右前扣带回尾部的节点中心性下降、35岁以上患者组出现左楔前叶和右扣带回的节点中心性下降,这些改变主要集中在默认网络(DMN)和突显网络(SN)。结论:不同年龄段SCZ患者DMN和SN中的节点中心性降低,可能代表SCZ的一种疾病特征,而仅在老年患者中观察到的网络变化可能代表与疾病阶段相关的脑损伤程度加重。

Objective:To explore the characteristics of the changes of grey matter network in untreated patients with schizophrenia at different ages,thus to better understand the development patterns of schizophrenia.Methods:150 untreated patients with schizophrenia and 152 matched healthy controls were included in this study.All patients and healthy controls were further divided into 4 subgroups by age respectively:A1 to A4 subgroup with age of 16~24,25~34,35~44 and≥45 years.High resolution T1-weighted imaging were obtained at a 3.0T MR scanner and the data were pre-processed using FreeSurfer package,and then the graphic grey matter network was constructed with the correlation of the cortical thickness between each pair of regions.Network metrices were calculated and compared to matched healthy controls to identify the network disorganization across different age stages.Results:Compared with the healthy controls,the reduction of small-world scalar(P=0.049)and local efficiency(P=0.033)was observed in the patients.In nodal properties,on the basis of common changes showed in all age subgroups,more network abnormalities were found in elder patient groups,including nodal centrality loss in the left isthmus cingulate(ICC)and right caudal anterior cingulate in patients over 25 and nodal centrality loss in the left precuneus and right ICC in patients over 35 years of age,which mainly within the default mode network(DMN)and salience network(SN).Conclusion:Decreased nodal centrality within the DMN and SN in schizophrenia patients across different age subgroups may represent disease traits in schizophrenia,while network changes observed only in the older subgroups may represent increased brain impairments associated with illness stage.