青少年精神分裂症局部自发性脑功能活动异常:一项基于静息态功能磁共振成像的元分析

Abnormalities of Regional Spontaneous Brain Functional Activity in Adolescent-Onset Schizophrenia:A Meta-Analysis of rs-MRI

目的 针对青少年精神分裂症(adolescent-onset schizophrenia, AOS)静息状态下局部自发性脑功能活动存在异常的脑区进行元分析,以确定AOS最为一致的异常脑区,并揭示AOS潜在的病理生理学机制。方法 检索PubMed、Web of Science、Embase英文数据库以及中国知网、万方中文数据库中采用低频波动幅度(amplitude of low-frequency fluctuation, ALFF)、分数低频波动幅度(fractional amplitude of low-frequency fluctuation, fALFF)及局部一致性(regional homogeneity, ReHo)的方法探究AOS患者静息状态下局部自发性脑功能活动异常改变的研究,时间为自建库起至2024年2月19日,提取并汇总AOS患者相对于健康对照者局部自发性脑功能活动存在异常的脑区,并采用SDM-PSI软件进行数据分析。结果 共纳入6篇符合标准的文献,样本量共计396例,其中AOS患者215例,健康对照组181名。基于体素的元分析结果显示:AOS患者左侧额中回延伸至额下回三角部局部自发性脑功能活动显著升高,左侧楔前叶延伸至后扣带回局部自发性脑功能活动降低(P<0.005;峰高Z>1;簇范围=10体素)。结论 基于体素的元分析证实在青少年期发病的精神分裂症存在相关核心脑区局部自发性脑功能活动的显著异常,这些发现将有助于进一步深化精神分裂症病理生理学机制的理解。

Objective A meta-analysis of brain regions with abnormal localized spontaneous brain functional activity in the resting state of adolescent-onset schizophrenia(AOS)was performed to identify the most consistent abnormal brain regions in AOS and to reveal the potential pathogenic mechanisms of AOS.Methods The PubMed,Web of Science,Embase English databases as well as CNKI and Wanfang Chinese databases were searched to explore studies on the AOS patients resting state abnormal changes in local spontaneous brain function using the methods of amplitude low-frequency fluctuation(ALFF),fractional amplitude low-frequency fluctuation(fALFF),and regional homogeneity(ReHo),from the time of database establishment until February 19,2024,to extract and summarize the brain regions in which there were abnormalities in the local spontaneous brain function activities of the AOS patients relative to those of the healthy controls,and to analyze the data using the SDM-PSI software.Results A total of 6 papers that met the criteria were included,with a total sample size of 396 cases,including 215 patients with AOS and 181 healthy controls.voxel-based meta-analysis showed that patients with AOS had a significant increase in localized spontaneous brain functional activity in the left middle frontal gyrus extending to the triangle of the inferior frontal gyrus,and a decrease in localized spontaneous brain functional activity in the left precuneus extending to the posterior cingulate gyrus(P<0.005;peak height Z>1;cluster range=10 voxels).Conclusion Voxel-based meta-analysis confirms the presence of significant abnormalities in localized spontaneous brain functional activity in relevant core brain regions in schizophrenia with onset in adolescence,and these findings will help to further deepen the understanding of the mechanisms underlying the pathophysiology of schizophrenia.