The Association Of Premorbid Abnormal Behavior With Brain Structure And Cognitive Function In First-episode Childhood Schizophrenia

ObjectiveAimed to survey premorbid abnormal behavior, brain structure and cognitive impairment of first-episode childhood schizophrenia. Meanwhile, to probe into the association of premorbid abnormal behavior with brain structure and cognitive function in first-episode childhood schizophrenia.Methods1.102first-episode childhood schizophrenia patients were chosen as the research object.2. With the method of Achenbach’s Child Behavior Check-list (CBCL), the childhood neurobehavioral characters in the first-episode childhood schizophrenia aged from4to5and6to11were assessed according to the memories of patients parents. The CBCL consisted of social competences and behaviour problems. And the behaviour problem part was subdivided into seven syndrome scales:the cleavage coercion, the depressive, the restless, somatic complaints, social withdrawn, aggressive behaviour and delinquent behaviour.3. The patients brain structure was measureed by magnetic resonance imaging(MRI). And the measurement indexes were comprised of transverse diameter of third ventricle, distance from lateral wall of third ventricle to left surface of insula and from lateral wall of third ventricle to right surface of insula, width of lateral ventricle anterior horn, largest width of lateral ventricle body, left horn of temporal, right horn of temporal, width of frontal sulci, width of parietal sulci, width of interhemispheric fissure, width of left lateral fissure, width of right lateral fissure, width of left head of caudate nucleus, width of right head of caudate nucleus and depth of corpus callosum.4. Their cognitive function assessment were measured before and after treatment by event-related potentials(ERP) P300and exploratory eye movement(EEM). Four parameters were measured:two from the P300test (amplitude and latency), and the others two from the EEM test(number of eye fixations[NEF] and responsive search score [RSS]).5. The differences of CBCL, between high score group and low score group in brain structure measurement values and between before and after treatment data of P300and EEM, were compared by Student’t test. Covariance matrix was used to analyse the difference of brain structure measurement values between high score group and low score groupe patients in CBCL. The relationship between the two in each eigenfactor score in CBCL, brain structure measurement values, the data before and after treatment of P300and EEM was analysed using Pearson correlation analysis. A significance level of0.05was used for all hypothesis tests.Results1. The trilateral relationship in social competencies of CBCL, cognitive function and brain structure in first-episode childhood schizophrenia.(1) Relationship between the social competencies of CBCL and the brain structure: the social competency total score was significantly positively correlated with the depth of corpus callosum at the age4to5(r=0.253, P<0.05). Similarly, it was also significantly positively correlated with width of right horn of temporal aged from6to11(r=0.345, P<0.01). However, it was significantly negatively correlated with the width of parietal sulci when aged4-5and6-11(r=-0.253,-0.273, P<0.05).(2) Relationship between the social competencies of CBCL and the cognitive function: the social competency total score was significantly negatively correlated with the latency of P300before treatment when aged from4to5and from6to11(r=-0.215,0.231, P<0.05). 2. The trilateral relationship in the behaviour problems of CBCL, cognitive function as well as brain structure in first-episode childhood schizophrenia.(1) Relationship between behaviour problems of CBCL and brain structure:Aged from4to5, the cleavage coercion score was significantly positively correlated with the width of lateral ventricle anterior horn(r=0.316, P<0.05). Moreover, the scores of depressed, somatic complaints, social withdrawns and behaviour problems were significantly positively correlated with the width of right lateral fissure(r=0.347,0.278,0.289,0.309, P<0.05, P<0.01). When aged from6to11, the cleavage coercion score and the depressive score were significantly positively correlated with the transverse diameter of third ventricle(r=0.301,0.264, P<0.05), but the behaviour problem score was significantly negatively correlated with the depth of corpus callosum(r=-0.252, P<0.05). However, the aggressive score was significantly negatively correlated with the depth of corpus callosum when aged4-5and6-11.(r=-0.291,-0.323,P<0.05, P<0.01).(2) Relationship between the behaviour problems of CBCL and cognitive function: the depressive score was significantly negatively correlated with the RSS before treatment at the age from4to5(r=-0.246, P<0.05), and the behaviour problem score was significantly negatively correlated with the NEF before treatment at the age from6to11(r=-0.227,P<0.05). But when aged from4to5and from6to11, the social withdrawal score was significantly negatively correlated with the NEF before treatment(r=-0.225,-0.344, P<0.05,P<0.01).3. The relationship between cognitive function and brain structure in first-episode childhood schizophrenia.The width of interhemispheric fissure was significantly positively correlated with the latency of P300after treatment(r=0.315, P<0.05), whereas the width of frontal sulci was significantly negatively correlated with the amplitude of P300after treatment(r=-0.353, P <0.05).Conclusion 1. The premorbid abnormal behavior and premorbid social competencies of first-episode childhood schizophrenia were significantly correlated with the brain structure. The lower social competencies, the much premorbid abnormal behavior, the more obvious on ventricular enlargement and the abnormal brain structure.2. The premorbid abnormal behavior and premorbid social competencies of first-episode childhood schizophrenia were significantly correlated with the cognitive function. The poorer premorbid abnormal behavior and lower social competencies, the more serious cognitive impairment.3. Cognitive function of first-episode childhood schizophrenia was significantly correlated with ventricular enlargement and abnormal brain structure. And the more obvious ventricular enlargement and abnormal brain structure, the more serious cognitive impairment.