Functional and Anatomical Connectivity Abnormalities in Cognitive Division of Anterior Cingulate Cortex in Schizophrenia

IntroductionCurrent pathophysiological theories of schizophrenia highlight the role of altered brain functional and anatomical connectivity. The cognitive division of anterior cingulate cortex (ACC-cd) is a commonly reported abnormal brain region in schizophrenia for its importance in cognitive control process. The aim of this study was to investigate the functional and anatomical connectivity of ACC-cd and its cognitive and clinical manifestation significance in schizophrenia by using the resting-state functional magnetic resonance imaging (fMRI) and the diffusion tensor imaging (DTI). MethodsThirty-three medicated schizophrenics and 30 well-matched health controls were recruited. Region-of-interest (ROI)-based resting-state functional connectivity analysis and Tract-Based Spatial Statistics (TBSS) were performed on 30 patients and 30 controls, and 24 patients and 29 controls, respectively. The Pearson correlation was performed between the imaging measures and the Stroop performance and scores of the Positive and Negative Syndrome Scale (PANSS), respectively. ResultsPatients with schizophrenia showed significantly abnormal in the functional connectivity and its hemispheric asymmetry of the ACC-cd with multiple brain areas, e.g., decreased positive connectivity with the bilateral putamen and caudate, increased negative connectivity with the left posterior cingulated cortex (PCC), increased asymmetry of connectivity strength with the contralateral inferior frontal gyrus (IFG). The FA of the right anterior cingulum was significantly decreased in patients group (p = 0.014). The abnormal functional and structural connectivity of ACC-cd were correlated with Stroop performance and the severity of the symptoms in patients. ConclusionsOur results suggested that the abnormal connectivity of the ACC-cd might play a role in the cognitive impairment and clinical symptoms in schizophrenia.引言 当前精神分裂症的病理生理学理论强调了大脑功能与解剖连接异常的致病作用。前扣带回认知亚区（cognitive division of anterior cingulate cortex, ACC-cd）是精神分裂症中被频繁报道的异常脑区，因其在认知控制过程中发挥关键作用。本研究旨在通过静息态功能磁共振成像（resting-state functional magnetic resonance imaging, fMRI）与弥散张量成像（diffusion tensor imaging, DTI），探究精神分裂症患者前扣带回认知亚区的功能与解剖连接模式，及其在认知与临床表型层面的意义。 研究方法 本研究共招募33名接受药物治疗的精神分裂症患者，以及30名匹配良好的健康对照者。分别对30例患者与30例健康对照、24例患者与29例健康对照开展基于感兴趣区（region-of-interest, ROI）的静息态功能连接分析，以及基于纤维束追踪的空间统计分析（Tract-Based Spatial Statistics, TBSS）。分别对影像学指标与斯特鲁普测验（Stroop test）成绩、阳性与阴性症状量表（Positive and Negative Syndrome Scale, PANSS）评分进行皮尔逊相关分析。 研究结果 精神分裂症患者的前扣带回认知亚区与多个脑区间的功能连接及其半球偏侧性均存在显著异常：例如，与双侧壳核及尾状核的正性功能连接减弱，与左侧后扣带回（posterior cingulated cortex, PCC）的负性功能连接增强，与对侧额下回（inferior frontal gyrus, IFG）的连接强度偏侧性升高。患者组右侧扣带回的各向异性分数（fractional anisotropy, FA）显著降低（p=0.014）。精神分裂症患者前扣带回认知亚区的异常功能与结构连接，均与斯特鲁普测验成绩及症状严重程度呈显著相关。 结论 本研究结果表明，前扣带回认知亚区的连接异常可能参与了精神分裂症的认知损害与临床症状的发生发展。