慢性精神分裂症患者认知功能与静息态脑镜像同伦连接的相关性

Correlation between cognitive function and resting-state interhemispheric voxel-mirrored homotopic connectivity in patients with chronic schizophrenia

背景认知功能受损是精神分裂症的核心临床特征,精神分裂症患者认知功能受损与大脑功能连接异常有关。目前关于慢性精神分裂症患者认知功能受损特征及其与双侧大脑半球间镜像同伦连接(VMHC)的相关性的研究仍不足。目的 分析经抗精神病药物治疗后病情稳定的慢性精神分裂症患者认知功能受损的特点及其与双侧大脑半球间VMHC的相关性,为探究慢性精神分裂症患者认知功能受损可能的神经生物学机制提供参考。方法 连续纳入2021年1月―2022年12月在苏州市广济医院住院、符合《国际疾病分类(第10版)》(ICD-10)精神分裂症诊断标准的慢性精神分裂症患者共15例,同期在社区招募15例健康志愿者为对照组。采用阳性和阴性症状量表(PANSS)评定患者的精神症状,采用重复性成套神经心理状态测验(RBANS)评定两组被试的认知功能。两组被试均进行静息态功能磁共振(rs-fMRI)扫描。应用基于VMHC方法进行数据分析。采用Pearson相关分析考查患者组差异脑区的VMHC值与PANSS和RBANS评分的相关性。结果 患者组RBANS的即刻记忆、视觉空间/结构、言语功能、注意以及总评分均低于对照组,差异均有统计学意义(t=-2.853、-2.107、-5.576、-7.108、-5.354,P<0.05或0.01)。与对照组相比,患者组左侧枕上回(t=-5.188,P<0.05)及右侧楔叶(t=-5.188,P<0.05)VMHC值更低,差异均有统计学意义。相关分析显示,患者组左侧枕上回(r=0.612,P=0.015)及右侧楔叶(r=0.612,P=0.015)VMHC值与RBANS的视觉空间/结构评分均呈正相关。结论 静息状态下,慢性精神分裂症患者左侧枕上回及右侧楔叶双侧半球间的VMHC存在异常,且与视觉空间/结构功能存在相关性。

Background Cognitive impairment,a core clinical feature of schizophrenia,is considered to be associated with the aberrant functional connectivity in patients with schizophrenia,whereas previous studies on the characteristics of cognitive impairment in patients with chronic schizophrenia and its correlation with interhemispheric voxel-mirrored homotopic connectivity(VMHC)are somewhat inadequate.Objective To investigate the characteristics of cognitive impairment in patients with chronic schizophrenia who are clinically stable on their antipsychotic medication,and to explore its correlation with resting-state interhemispheric VMHC,so as to provide theoretical basis for the identification of neurobiological mechanism possibly responsible for cognitive impairment in chronic schizophrenia.Methods A total of 15 patients with chronic schizophrenia who met the criteria of the International Classification of Diseases,tenth edition(ICD-10)and hospitalized in Suzhou Guangji Hospital from January 2021 to December 2022 were included.Another 15 healthy community-dwelling individuals were concurrently recruited.All participants were requested to complete the Positive and Negative Symptom Scale(PANSS),Repeatable Battery for the Assessment of Neuropsychological Status(RBANS)and resting-state functional Magnetic Resonance Imaging(rs-fMRI)scanning to evaluate their mental symptoms,cognitive function and interhemispheric functional connectivity.The rs-fMRI data were analyzed with VMHC method.Then Pearson correlation analysis was performed to examine the correlation between VMHC values of regions of interest and scores of RBANS and PANSS within patient group.Results Patient group obtained lower scores than control group based on RBANS immediate memory,visuospatial/constructional,language,attention and total score,with statistically significant differences(t=-2.853,-2.107,-5.576,-7.108,-5.354,P<0.05 or 0.01).The VMHC values of left superior occipital gyrus(t=-5.188,P<0.05)and right cuneus(t=-5.188,P<0.05)in patient group were lower than those in control group,with statistical difference.Correlation analysis denoted that the VMHC values of left superior occipital gyrus(r=0.612,P=0.015)and right cuneus(r=0.612,P=0.015)were positively correlated with visuospatial/constructional index score in RBANS.Conclusion The resting-state VMHC is abnormal in left superior occipital gyrus and right cuneus of patients with chronic schizophrenia,and yields a correlation with the visuospatial/constructional performance of patients.