精神分裂症患者纹状体功能障碍评分与症状及认知功能的相关性

Correlation between functional striatal abnormalities scores and symptoms and cognitive function in patients with schizophrenia

目的探讨纹状体功能障碍(FSA)评分与精神分裂症患者症状及认知功能的相关性。方法选择2021年7月至2022年2月新乡医学院第二附属医院收治的92例精神分裂症患者为研究对象,15例患者在影像数据分析时因头部活动干扰过大而被剔除,最终77例患者纳入统计分析。采用认知功能成套测验评估患者治疗前及治疗8周后的认知功能。应用阳性与阴性症状量表(PANSS)对患者治疗前及治疗8周后的症状严重程度进行评估,并根据PANSS减分率将患者分为无效组(PANSS减分率<50%,n=33)和有效组(PANSS减分率≥50%,n=44)。分别于治疗前和治疗8周后,对患者进行静息态功能磁共振成像扫描并计算FSA评分。结果治疗前,有效组与无效组患者的FSA评分比较差异无统计学意义(P>0.05)。2组患者治疗8周后FSA评分均显著高于治疗前(P<0.05)。治疗8周后,有效组与无效组患者的FSA评分比较差异无统计学意义(P>0.05)。治疗前和治疗8周后,2组患者的FSA评分与PANSS总分、阳性因子得分、阴性因子得分和病理因子得分均无显著相关性(P>0.05)。2组患者治疗前FSA评分与治疗前后阳性因子得分差值、阴性因子得分差值、病理因子得分差值均无显著相关性(P>0.05)。有效组患者治疗前FSA评分与空间广度得分呈显著负相关(P<0.05),与范畴流畅得分呈显著正相关(P<0.05);有效组患者治疗前FSA评分与连线测验、符号编码、词语学习、迷宫、视觉空间记忆、持续操作-2D、持续操作-3D、持续操作-4D得分均无显著相关性(P>0.05)。无效组患者治疗前FSA评分与空间广度、持续操作-4D得分呈显著负相关(P<0.05);无效组患者治疗前FSA评分与连线测验、符号编码、词语学习、迷宫、视觉空间记忆、范畴流畅、持续操作-2D、持续操作-3D得分均无显著相关性(P>0.05)。有效组患者治疗后FSA评分与各项认知功能得分均无显著相关性(P>0.05)。无效组患者治疗后FSA评分与连线测验得分呈显著正相关(P<0.05),无效组患者治疗后FSA评分与符号编码、词语学习、空间广度、迷宫、视觉空间记忆、范畴流畅、持续操作-2D、持续操作-3D及持续操作-4D测验得分无显著相关性(P>0.05)。结论精神分裂症患者的FSA评分经过治疗后显著上升,FSA评分可能与症状严重程度及治疗反应无关,但与信息处理速度这一认知功能之间存在相关性。

Objective To explore the correlation between functional striatal abnormalities(FSA)scores and symptoms and cognitive function in patients with schizophrenia.Methods A total of 92 patients with schizophrenia admitted to the Second Affiliated Hospital of Xinxiang Medical University from July 2021 to February 2022 were selected as the research subjects,15 patients were excluded due to excessive interference with head movement during image data analysis,and 77 patients were finally included in the statistical analysis.The cognitive function of the patients before treatment and after 8 weeks of treatment was evaluated through a set of cognitive function tests.The severity of symptoms before treatment and after 8 weeks of treatment was evaluated according to the positive and negative symptom scale(PANSS).The patients were divided into the ineffective group(PANSS<50%,n=33)and the effective group(PANSS≥50%,n=44)according to the PANSS reduction rate.Before treatment and 8 weeks after treatment,the resting-state functional magnetic resonance imaging scans were performed,and FSA scores were calculated.Results There was no significant difference in FSA scores of patients between the effective group and the ineffective group before treatment(P>0.05).After 8 weeks of treatment,the FSA scores of patients in the two groups were significantly higher than those before treatment(P<0.05).After 8 weeks of treatment,there was no significant difference in FSA scores of patients between the effective group and the ineffective group(P>0.05).Before treatment and after 8 weeks of treatment,there was no significant correlation between the FSA scores and the total PANSS scores,positive factor scores,negative factor scores and pathological factor scores in the two groups(P>0.05).There was no significant correlation between the pre-treatment FSA scores and the differences in positive factor scores,negative factor scores and pathological factor scores before and after treatment in both groups(P>0.05).In the effective group,the FSA score was significantly negatively correlated with the spatial span score(P<0.05)and significantly positively correlated with the category fluency score(P<0.05)before treatment;however,there was no significant correlation between the pre-treatment FSA score and the scores of trail making,symbol coding,word learning,maze solving,visuospatial memory,2-digit continuous performance,3-digit continuous performance and 4-digit continuous performance(P>0.05).In the ineffective group,there was a significant negative correlation between the pre-treatment FSA score and the spatial span and 4-digit continuous performance scores(P<0.05),while there was no significant correlation between the pre-treatment FSA score and the scores of trail making,symbol coding,word learning,maze solving,visuospatial memory,category fluency,2-digit continuous performance and 3-digit continuous performance(P>0.05).There was no significant correlation between the FSA score and cognitive function scores after treatment in the effective group(P>0.05).There was a significant positive correlation between the FSA score and the trail making score after treatment in the ineffective group(P<0.05),but there was no significant correlation between the FSA score and the scores of symbol coding,word learning,spatial span,maze solving,visuospatial memory,category fluency,2-digit continuous performance,3-digit continuous performance and 4-digit continuous performance(P>0.05).Conclusion FSA scores in patients with schizophrenia increase significantly after treatment.FSA scores may not be related to the severity of symptoms or treatment response,but are correlated with the cognitive function of information processing speed.