以阳性症状为主精神分裂症患者的静息态脑功能网络特征

Characteristics of resting-state brain functional networks in patients with schizophrenia positive symptoms

目的:探索以阳性症状为主的精神分裂症患者的静息态脑功能网络特征。方法:纳入符合DSM-IV精神分裂症诊断标准的以阳性症状为主患者100例和70例健康成人,采用阳性和阴性症状量表(PANSS)评估患者的临床症状,并完成静息态磁共振成像扫描。通过独立成分分析(ICA)方法比较两组听觉网络、执行网络和凸显网络间的功能连接及网络内功能连接,并对两组间存在差异的脑功能连接指标与精神病性症状和认知功能得分进行相关性分析。结果:与对照组相比,患者组听觉网络与凸显网络间的功能连接增加[(0.49±0.27)vs.(0.38±0.23)],同时听觉网络与执行网络[左侧:(-0.10±0.22vs.(0.002±0.21);右侧:(-0.05±0.24)vs.(0.05±0.21)]及凸显网络与执行网络间功能连接[(0.001±0.28)vs.(0.11±0.24)]降低。网络内功能连接分析显示,患者组听觉网络的左侧颞上回功能连接降低,以及执行网络的脑岛和顶下小叶脑区功能连接降低。相关分析发现,前凸显网络和右执行网络间的功能连接与冲动性行为呈负相关(r=-0.24,P<0.05),听觉网络和右执行网络间的功能连接和概念紊乱症状呈负相关(r=-0.23,P<0.05)。结论:以阳性症状为主的精神分裂症型患者可能存在听觉网络、执行网络及凸显网络的功能连接异常。

Objective:To investigate the features of brain network connectivity in patients with schizophreniapositive symptoms.Methods:Totally 100 patients with schizophrenia positive symptoms according to DSM-Ⅳand 70 normal controls were scanned with resting state functional magnetic resonance imaging(rs-fMRI).The Positive and Negative Syndrome Scale(PANSS)was used for the quantification of symptom severity of patients with schizophrenia.Independent component analysis was conducted on imaging data,and auditory network,salience network,and executive control network were especially focused on in this study.Correlation analyses were performed between brain functional measurements and clinical characteristics of the patients.Results:Compared with normal controls,patients with schizophrenia presented an increase in functional connectivity(FC)between the auditory network and salience network(0.49±0.27 vs.0.38±0.23)and decreases in FC between auditory network and executive control network[left:(-0.10±0.22)vs.(0.002±0.21);right:(-0.05±0.24)vs.(0.05±0.21)]and in FC between salience network and executive control network[(0.001±0.28)vs.(0.11±0.24)].Meanwhile,FC in the left superior temporal gyrus,insular,and inferior partial lobule decreased in patients.The decreased FC between anterior salience network and right executive control network was negatively correlated with hostility(r=-0.24,P<0.05),and the decreased FC between auditory network and right executive control network was negatively correlated with conceptual disorganization(r=-0.23,P<0.05).Conclusion:It suggests that abnormal functional connectivity within and between perceptual systems(auditory network and salience network)and executive control networks may be the physiological basis of positive symptoms.