精神分裂症患者全脑异常功能连接与临床变量的关联研究

An investigation on the associations between brain abnormal functional connectivity and clinical variables in patients with schizophrenia

目的探讨精神分裂症患者静息态功能连接(functional connectivity,FC)异常及其与临床变量的相关性。方法纳入112例精神分裂症患者和119名健康对照者。采集患者的临床特征、症状、功能等36项临床变量资料。获取所有被试的全脑静息态功能磁共振数据,将全脑划分为116个脑区,并计算两两脑区间的FC度量。结果相比于对照组,精神分裂症组异常FC共365条(P<2.539×10^(-4)),包括169条异常增强的连接(其中80条与小脑有关)和196条异常减弱的连接(其中101条与小脑有关)。与临床变量的相关分析共发现14对有统计学相关性的异常FC与临床变量(P<5.823×10^(-4)),其中异常FC涉及枕叶与顶叶、枕叶与小脑、扣带与顶叶、扣带与岛叶、扣带与小脑及丘脑与小脑,而临床变量涉及精神分裂症生活质量量表(schizophrenia quality of life scale,SQLS)总分、SQLS社会心理分、思维语言和沟通能力评估量表(scale for the assessment of thought,language,and communication,TLC)的语言障碍加权分、阳性症状量表(scale for the assessment of positive symptoms,SAPS)总分、SAPS怪异行为分、阳性和阴性症状量表(positive and negative syndrome scale,PANSS)的思维障碍分、PANSS攻击性(补充)分、首发年龄。结论精神分裂症患者存在全脑广泛分布的FC异常,部分异常FC与临床变量有统计学相关性。在异常FC中,与小脑相关的FC接近一半,提示小脑可能在精神分裂症的病理机制中发挥重要作用。

Objective To investigate the associations between resting-state brain functional connectivity(FC)abnormalities and clinical variables in patients with schizophrenia.Methods Participants included 112 patients with schizophrenia and 119 healthy controls.Resting-state functional magnetic resonance imaging(rs-fMRI)data of the whole brain were acquired from all participants.The whole brain was divided into 116 regions and the FC between each pair of the regions was calculated.Thirty-six clinical variables such as clinical features,symptoms and functions were assessed in all patients.Results Compared with the healthy controls,365 abnormal FCs were identified in patients(P<2.539×10^(-4)),including 169 significantly increased FCs(80 were related to the cerebellum)and 196 significantly decreased FCs(101 were related to the cerebellum).The correlation analyses between abnormal FCs and clinical variables in patients identified 14 significant associations(P<5.823×10^(-4)),mainly involving the FCs between occipital and parietal lobes,between occipital lobe and cerebellum,between cingulate gyrus and parietal lobe,between cingulate gyrus and insula,between cingulate gyrus and cerebellum,and between thalamus and cerebellum.The clinical variables such as the total score of the Schizophrenia Quality of Life Scale(SQLS),the psychosocial score of SQLS,the weighted score of language disorder of the scale for the Assessment of Thought,Language,and Communication(TLC),the total score of the Scale for the Assessment of Positive Symptoms(SAPS),the score of bizarre behavior of SAPS,the score of thought disturbance of the Positive and Negative Syndrome Scale(PANSS),the supplementary aggression score of PANSS,and the onset age.Conclusion The abnormal FCs were widely distributed in the whole brain of patients with schizophrenia,some of which were significantly correlated with patients’clinical variables.In addition,approximately half of the abnormal FCs were related to the cerebellum,suggesting that the cerebellum may play an important role in the pathological mechanisms of schizophrenia.