姚洪超,吴俊林,李宏伟,卓丽华,黄国平,冯若涵,刘芮杉,王露,李真林.首发未用药青少年精神分裂症患者双侧楔前叶的功能及有效连接的网络异常[J].四川精神卫生杂志,2023,(5):402-408.Yao Hongchao,Wu Junlin,Li Hongwei,Zhuo Lihua,Huang Guoping,Feng Ruohan,Liu Ruishan,Wang Lu,Li Zhenlin,Study on altered functional and effective connectivity of bilateral precuneus in drug-naïve first-episode patients with adolescent-onset schizophrenia[J].SICHUAN MENTAL HEALTH,2023,(5):402-408
首发未用药青少年精神分裂症患者双侧楔前叶的功能及有效连接的网络异常
Study on altered functional and effective connectivity of bilateral precuneus in drug-naïve first-episode patients with adolescent-onset schizophrenia
投稿时间:2023-08-28  
DOI:10.11886/scjsws20230828001
中文关键词:  青少年  精神分裂症  楔前叶  MRI成像  静息态
英文关键词:Adolescent  Schizophrenia  Precuneus  MRI  Resting state
基金项目:国家重点研发计划(项目名称:AD/PD的精神影像早期预警和早期诊断特征的研究,项目编号:2022YFC2009901;项目名称:基于精神影像的老年神经退行性疾病多组学智能诊断研究,项目编号:2022YFC2009900)
作者单位邮编
姚洪超 四川大学华西医院 四川 成都 610044
四川省精神卫生中心·绵阳市第三人民医院 四川 绵阳 621000 
621000
吴俊林 四川省精神卫生中心·绵阳市第三人民医院 四川 绵阳 621000 621000
李宏伟 四川省精神卫生中心·绵阳市第三人民医院 四川 绵阳 621000 621000
卓丽华 四川省精神卫生中心·绵阳市第三人民医院 四川 绵阳 621000 621000
黄国平 四川省精神卫生中心·绵阳市第三人民医院 四川 绵阳 621000 621000
冯若涵 四川省精神卫生中心·绵阳市第三人民医院 四川 绵阳 621000 621000
刘芮杉 四川省精神卫生中心·绵阳市第三人民医院 四川 绵阳 621000 621000
王露 四川省精神卫生中心·绵阳市第三人民医院 四川 绵阳 621000 621000
李真林* 四川大学华西医院 四川 成都 610044 610044
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中文摘要:
      背景 与成年发病的精神分裂症患者相比,青少年精神分裂症患者具有基因易感性更高,阴性症状更严重,复发率更高,预后和社会功能恢复不良等特点。明确青少年精神分裂症患者脑功能异常改变对进一步阐明疾病的发病机制、探索个体化精准治疗具有重要意义。 目的 探索首发青少年精神分裂症患者静息状态下双侧楔前叶功能及有效连接的异常改变,为青少年精神分裂症患者的脑影像机制研究提供影像学参考。 方法 纳入符合《精神障碍诊断与统计手册(第5版)》(DSM-5)精神分裂症诊断标准的首发未用药青少年精神分裂症患者21例,同期纳入年龄、受教育程度、性别相匹配的健康对照组21例。对青少年精神分裂症患者的临床症状评估采用精神症状评定量表(PSYRAT)以及阳性和阴性症状量表(PANSS)。所有被试均进行静息态功能磁共振成像扫描,以双侧楔叶为种子点进行功能及有效连接分析,计算其与全脑的功能连接图,并分析功能连接强度与临床症状的相关性。 结果 在功能连接方面,患者组双侧楔前叶与左侧颞中回的功能连接高于健康对照组( P<0.01,FWE校正,簇水平 P<0.05);在有效连接方面,与健康对照组比较,患者组表现出从种子区到左侧额中回的负反馈效应。相关分析结果显示,患者组从双侧楔前叶到左侧额中回有效连接减低与PANSS总评分呈正相关( r=0.450, P<0.05)。 结论 首发青少年精神分裂症患者静息态下双侧楔前叶功能连接及有效连接网络模式可能存在异常,其中双侧楔前叶与左侧额中回的有效连接减弱可能与患者精神症状相关。
英文摘要:
      Background Compared with adult-onset schizophrenia, patients with adolescent-onset schizophrenia experience a high genetic susceptibility, severe negative symptoms, high recurrence rate, poor prognosis and social function recovery. And clarifying the brain functional alterations in adolescent-onset schizophrenia is of great significance for further elucidating the pathogenesis of the disease and exploring personalized and precise treatment. Objective To investigate the altered functional and effective connectivity of bilateral precuneus in first-episode patients with adolescent-onset schizophrenia based on resting-state functional magnetic resonance imaging (rs-fMRI), thus providing reliable imaging evidence in guiding the study on mechanism involved in adolescent-onset schizophrenia. Methods Twenty-one drugna?ve first-episode patients with adolescent-onset schizophrenia who met the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) criteria for schizophrenia were enrolled, and another 21 psychiatrially healthy controls matched on age, educational background and gender were concurrently selected. The schizophrenic subjects were evaluated using the Psychotic Symptom Rating Scales (PSYRATS) and Positive and Negative Symptom Scale (PANSS). All participants underwent rs-fMRI scans, and the whole-brain seed-based functional and effective connectivity analyses were conducted in bilateral cuneus region. Then the correlation between functional connectivity strength and clinical symptoms of patients was discussed. Results In terms of functional connectivity, the functional connectivity of bilateral precuneus and left middle temporal gyrus was increased in patient group compared with healthy control group [ P<0.01, family-wise error (FWE) correction at cluster level, P<0.05]. In terms of effective connectivity, patient group responded to negative feedback with greater activation of seed region and left middle frontal gyrus than healthy control group. Correlation analysis within patient group denoted that the decreased effective connectivity of bilateral precuneus and left middle frontal gyrus was positively correlated with the total PANSS score ( r=0.450, P<0.05). Conclusion The resting-state functional and effective connectivity of bilateral precuneus is abnormally alerted in drugna?ve first-episode patients with adolescent-onset schizophrenia, and the decreased effective connectivity of bilateral precuneus and left middle frontal gyrus may be related to the development of clinical symptoms. [Funded by National Key Research and Development Program of China (number, 2022YFC2009901, 2022YFC2009900)]
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