背景:皮质厚度(CT)改变,失配消极性(MMN)减少,和认知缺陷是首发精神病(FEP)的有力发现。然而,大多数研究集中在药物治疗的患者,在我们对CT之间相互关系的理解上留下了空白,MMN,神经认知,和未用药的FEP的社会心理功能。本研究旨在采用多重中介分析来研究未用药的未用药的FEP中这些变量之间的潜在途径。
方法:我们招募了28名未经药物治疗的FEP和34名年龄和性别匹配的健康对照。临床症状,神经认知,社会心理功能,听觉持续时间MMN,收集T1结构磁共振成像数据。我们测量了颞上回(STG)的CT,主MMN生成区域。
结果:我们发现FEP中MMN振幅与STG(CT_STG)的双侧CT之间存在显着负相关(左:r=-.709,P<.001;右:r=-.612,P=.008)。多重调解模型显示,较薄的左STG皮层通过直接效应(24.66%)和间接效应(75.34%)影响功能。相比之下,正确的CT_STG对功能的影响主要通过MMN和神经认知途径介导。
结论:双侧CT_STG与MMN显著相关,MMN在CT和认知之间起中介作用。单独的MMN及其与认知的相互作用都介导了结构改变对心理社会功能的影响。FEP整体功能的下降可能源于CT_STG的降低,导致随后的MMN缺陷和神经认知功能障碍。这些发现强调了MMN在阐明微妙的结构改变如何影响FEP中的神经认知和心理社会功能方面的关键作用。
BACKGROUND: Cortical thickness (CT) alterations, mismatch negativity (MMN) reductions, and cognitive deficits are robust findings in first-episode psychosis (FEP). However, most studies focused on medicated patients, leaving gaps in our understanding of the interrelationships between CT, MMN, neurocognition, and psychosocial functioning in unmedicated FEP. This study aimed to employ multiple mediation analysis to investigate potential pathways among these variables in unmedicated drug-naïve FEP.
METHODS: We enrolled 28 drug-naïve FEP and 34 age and sex-matched healthy controls. Clinical symptoms, neurocognition, psychosocial functioning, auditory duration MMN, and T1 structural magnetic resonance imaging data were collected. We measured CT in the superior temporal gyrus (STG), a primary MMN-generating region.
RESULTS: We found a significant negative correlation between MMN amplitude and bilateral CT of STG (CT_STG) in FEP (left: r = -.709, P < .001; right: r = -.612, P = .008). Multiple mediation models revealed that a thinner left STG cortex affected functioning through both direct (24.66%) and indirect effects (75.34%). In contrast, the effects of the right CT_STG on functioning were mainly mediated through MMN and neurocognitive pathways.
CONCLUSIONS: Bilateral CT_STG showed significant association with MMN, and MMN plays a mediating role between CT and cognition. Both MMN alone and its interaction with cognition mediated the effects of structural alterations on psychosocial function. The decline in overall function in FEP may stem from decreased CT_STG, leading to subsequent MMN deficits and neurocognitive dysfunction. These findings underline the crucial role of MMN in elucidating how subtle structural alterations can impact neurocognition and psychosocial function in FEP.