An Association Study on the Cognitive Function and the Cerebral Grey Matter Volume of Patients with First-Episode Schizophrenia

Shanghai Arch Psychiatry. 2018 Jun 25;30(3):154-167. doi: 10.11919/j.issn.1002-0829.217138.

Abstract

Background: The impairment of cognitive function is one of the core symptoms in schizophrenia, and the degree of recovery is closely related to whether patients are able to rejoin society successfully.

Objective: This study was to clarify the correlation between cognitive function and cerebral grey matter volume in schizophrenia.

Methods: The neuro-cognitive functions of thirty-seven patients with first-episode schizophrenia (the patient group) and thirty healthy controls (the control group) was evaluated with the Clock Drawing Test, Trail Marking Test, Digit Span Test, Auditory Verbal Learning Test, Wisconsin Card Sorting Test, Verbal Fluency Test, Semantic Similarity Test and Stroop Color-Word Test. The facial emotion cognitive task was employed to assess the facial emotion cognitive functions of thirty-two patients with first-episode schizophrenia (the patient group) and 29 healthy controls (the control group). The psychotic symptoms of patients with first-episode schizophrenia were evaluated using the Positive and Negative Syndrome Scale (PANSS). The brain imaging data of the patient group and control group were collected using the magnetic resonance imagine (MRI).

Results: The difference between the patient group and the control group in the results of Clock Drawing Test, Trail Marking Test, Digit Span Test, Auditory Verbal Learning Test, Wisconsin Card Sorting Test, Verbal Fluency Test, Semantic Similarity Test and Stroop Color-Word Test's reaction time were significant. These two groups' Slopes in the facial emotion cognitive task were also significantly different from each other. According to the comparison of cerebral grey matter volume between the patient group and the control group, it was found that the grey matter volume of the patient group increased in the left superior frontal gyrus, and decreased in the left occipital gyrus, lingual gyrus and upper cerebellum. Based on the analyses of neuro-cognitive data and brain imaging data of the patient group, the scores of the number of correct responses in Stroop Color-Word Test's Card C were negatively correlated with grey matter volumes of the left upper frontal gyrus, right upper frontal gyrus and middle frontal gyrus. The analyses on the facial emotion cognitive task and brain imaging data of the patient group showed that the slope data were positively correlated with grey matter volumes of the right superior temporal gyrus, middle temporal gyrus, left middle temporal gyrus, inferior temporal gyrus and fusiform gyrus.

Conclusion: There are general impairments in the neuro-cognitive functions and facial emotion cognitive functions of patients with first-episode schizophrenia, and the results suggest that brain areas with abnormal grey matter volumes are likely to be the brain structure and functional basis of the cognitive impairments.

背景: 认知功能损害是精神分裂症的核心症状之一, 其恢复程度关系到患者能否重新回归社会。.

目的: 明确精神分裂症认知功能与脑灰质体积的关系。.

方法: 采用画钟测试、连线测试、数字广度测试、听 觉词语测试、威斯康星卡片分类测验、言语流畅性测 试、语义相似性测验、斯特鲁色词测试对37 例首发精 神分裂症住院患者(病例组)和30 名健康对照组(对 照组)进行神经认知功能检测,采用面孔情绪认知任 务测试对32 例首发精神分裂症住院患者(病例组)和 29 名健康对照组(对照组)进行面孔情绪认知功能检 测,采用阳性和阴性症状量表(Positive and Negative Syndrome Scale ,PANSS)评定首发精神分裂症住院患 者的精神症状,利用磁共振分别对病例组和对照组进 行脑部影像学数据的采集。.

结果: 病例组和对照组在画钟测试、连线测试、数字 广度测验、听觉词语测验、威斯康星卡片分类测验、 言语流畅性测验、语义相似性测验、斯特鲁色词测验 反应时间中,两组间的差异有统计学意义;面孔情绪 认知任务测试斜率(Slope)之间有统计学意义;病例 组与对照组的脑灰质体积差异比较发现病例组的左侧 额上回的灰质体积增加,左侧枕下回、舌回和小脑上 部灰质体积减少;病例组神经认知数据与脑影像学数 据分析,斯特鲁色词测验中的卡片C 正确反应个数测 验分数,显示与左侧额上回和右侧额上回、额中回灰 质体积负相关;病例组面孔情绪认知任务与脑影像学 数据分析,病例组转换斜率数据的相关灰质异常脑区 为与右侧颞上回、颞中回,左侧颞中回、颞下回和梭 状回灰质体积成正相关。.

结论: 首发精神分裂症住院患者的神经认知功能和面 孔情绪认知功能存在广泛性损害,上述结果提示灰质 体积异常脑区可能为认知功能障碍的脑结构和功能基 础。.

Keywords: facial emotion cognition; first-episode schizophrenia; grey matter volume; neuro-cognition.