背景:证据表明,精神分裂症(SZ)患者在抗精神病药物治疗期间的功能连接发生了显着变化。尽管以前有精神分裂症患者的脑网络程度中心性(DC)变化的报道,SZ患者抗精神病药物治疗后脑DC变化与神经认知改善之间的关系仍然难以捉摸。
方法:共纳入74例慢性SZ急性发作患者和53例年龄和性别相匹配的健康对照。阳性和阴性综合征量表(PANSS)符号数字模式测试,数字跨度测试(DST),采用言语流畅性测验评价SZ患者的临床症状和认知表现。SZ患者从基线开始接受抗精神病药物治疗六周,并在基线和六周后接受MRI和临床访谈,分别。然后,我们根据PANSS评分将SZ患者分为有反应(RS)和无反应(NRS)组(PANSS降低率≥50%)。计算并分析DC以确定其与临床症状和认知表现的相关性。
结果:抗精神病药物治疗后,SZ患者临床症状明显改善,语义流畅性表现。相关分析显示,治疗后左前下顶叶(aIPL)DC升高程度与兴奋评分变化呈负相关(r=-0.256,p=0.048,调整后p=0.080),但这种相关性未能通过多次测试校正。SZ患者治疗后左aIPLDC值与DST评分呈显著负相关,在基线时未观察到(r=-0.359,p=0.005,调整后p=0.047)。此外,我们没有发现RS组和NRS组之间DC的显著差异,无论是在基线还是在治疗后。
结论:结果表明,抗精神病药物治疗后SZ患者的DC变化与神经认知能力相关。我们的发现为SZ抗精神病药物治疗的神经病理学机制提供了新的见解。
BACKGROUND: Evidence indicates that patients with schizophrenia (SZ) experience significant changes in their functional connectivity during antipsychotic treatment. Despite previous reports of changes in brain network degree centrality (DC) in patients with schizophrenia, the relationship between brain DC changes and neurocognitive improvement in patients with SZ after antipsychotic treatment remains elusive.
METHODS: A total of 74 patients with acute episodes of chronic SZ and 53 age- and sex-matched healthy controls were recruited. The Positive and Negative Syndrome Scale (PANSS), Symbol Digit Modalities Test, digital span test (DST), and verbal fluency test were used to evaluate the clinical symptoms and cognitive performance of the patients with SZ. Patients with SZ were treated with antipsychotics for six weeks starting at baseline and underwent MRI and clinical interviews at baseline and after six weeks, respectively. We then divided the patients with SZ into responding (RS) and non-responding (NRS) groups based on the PANSS scores (reduction rate of PANSS ≥50%). DC was calculated and analyzed to determine its correlation with clinical symptoms and cognitive performance.
RESULTS: After antipsychotic treatment, the patients with SZ showed significant improvements in clinical symptoms, semantic fluency performance. Correlation analysis revealed that the degree of DC increase in the left anterior inferior parietal lobe (aIPL) after treatment was negatively correlated with changes in the excitement score (r = -0.256, p = 0.048, adjusted p = 0.080), but this correlation failed the multiple test correction. Patients with SZ showed a significant negative correlation between DC values in the left aIPL and DST scores after treatment, which was not observed at the baseline (r = -0.359, p = 0.005, adjusted p = 0.047). In addition, we did not find a significant difference in DC between the RS and NRS groups, neither at baseline nor after treatment.
CONCLUSIONS: The results suggested that DC changes in patients with SZ after antipsychotic treatment are correlated with neurocognitive performance. Our findings provide new insights into the neuropathological mechanisms underlying antipsychotic treatment of SZ.