Study Of Resting-state MRI In Childhood And Adolescence-onset Schizophrenia

BackgroundSchizophrenia is a highly heritable,heterogeneous and complex brain disorder.Many symptoms hidden onset during adolescence,The clinical manifestations that mental activities isn't in harmony with the environment,has a tendency to chronic and recession,condition fluctuation of an illness is difficult to predict,many symptoms(such as suicide and murder delusion,commanding voices,etc.)the emergence of serious affect the safety of the patient's own,family and society,even to the people's life and national property caused huge losses.Childhood and adolescence onset schizophrenia(CO-SZ)are defined as onset of psychosis before age 18,compared with adult onset of patients,CO-SZ patients abnormal neurological development is more obvious,clinical symptoms are more outstanding,treatment and prognosis is worse.There are many studies have found that magnetic resonance imaging of the brain in patients with schizophrenia has demonstrated abundant morphological abnormalities including enlargement of ventricles,Cortical and sub-cortical atrophy.Our previous research found that CO-SZ patients have shown similar abnormalities.The study of children schizophrenia brain function is less.This study proposed by Magnetic Resonance Imaging(MRI)from two aspects of the structure and function testing,for CO-SZ pathophysiology mechanisms of exploring clues.ObjectivesCO-SZ by analyzing the starting areas of the brain white matter and gray matter volume change and resting state brain imaging characteristics of pathophysiology mechanism for CO-SZ explore clues.Methods1.Participants: This study will select 45 cases in accordance with the Diagnostic and Statistical Manual of Mental Disorder-IV(DSM-IV)and Chinese mental disease classification and diagnostic criteria in the fourth edition(CCMD-4)diagnostic criteria of CO-SZ as case group,and in strict accordance with the degree of gender,age,nationality and education matching principle to choose 39 cases of normal controls.2.The structure of image data processing and analysis: Its program respectively is: the format of reconstruction,the space of standardization,the image of segmentation,brain volume of computing,smooth and so an.Finally,grey and white matter volume were analyzed after the smooth.Matlab platform(The MathWorks,Inc.,Natick,Massachusetts)is used,based on SPM8(Statistical Parametric Mapping,http://www.fil.ion.ucl.ac.uk/spm)of VBM8(voxel--based morphometry.The DBM.Neuro.Uni-jena.DE/VBM)and REST(RS-fMRI Data Analysis Toolkit,http://www.restfmri.net)software.3.Brain imaging and analysis: Using functional magnetic resonance imaging(fMRI)3.0 system to check the whole brain resting state fMRI of all the subjects.DPARSF software was used to analyze the imaging date of preprocessing.All study controls were studied using Resting-State fMRI Data Analysis Toolkit(REST)software to obtain the areas of the brain where the ALFF changes were statistically significant.Selecting the areas of the brain where the ALFF changes as seeds point to find the areas of the whole brain where were statistically significant connection with seed point.Results1.The comparison of brain structure between patients group and healthy group? The comparison of white matter volume between two group: compared with healthy group,patients group showed significant reduce in left frontal lobe,right limbic lobe,left cingulate gyrus,MNl coordinate:x=-27?18?-21,y=12?-9?-18,z=21?39?45;voxels:116?411?76;t=-4.4132?-5.0232?-5.2164;Alphasim corrected,corrected p<0.05.? The comparison of grey matter volume between two group: compared with healthy group,patients group showed significant reduce in right insula,left inferior frontal gyrus,left limbic lobe,MNl coordinate:x=36?54?0,y=21?18?45,z=3?9?27;voxels:42?37?83;t=-5.303?-5.3016?-6.211;Alphasim corrected,corrected p<0.05.2.The result of ALFF and functional connectivity between patients group and healthy group(1)ALFF results: Compared with healthy group,patients group showed significantly decreased ALFF in the left lingual,left temporal lobe and frontal lobe,MNl coordinate:x=0?-54?0,y=-63?-21?-27,z=9?0?69;voxels:225?84?143;t=-4.8201?-4.3652?-4.7325;Alphasim corrected,corrected p<0.05.(2)functional connectivity results: Selecting the areas of the brain where the ALFF depressed as seeds point to analysis the resting state dysfunctional connection of the whole brain regions.When the left lingual(MNl coordinate:x=0,y=-63,z=9)was used as seed,compared to healthy group,reduced connectivities were observed in the right superior temporal gyrus,left superior temporal gyrus,right insula,left frontal lobe,right parietal lobe,MNl coordinate:x=66?-51?63?-33?-6,y=-36?-21?-18?-21?-33,z=12?3?9?54?72;voxels:123?196?164?158?190;t=-4.586?-4.448?-4.1543?-5.0523?-4.8143;FDR corrected p<0.05.When the left temporal lobe(MNl coordinate:x=-54,y=-21,z=0)was used as seed,compared to healthy group,reduced connectivities were observed in the right occipital lobe,right medial frontal gyrus,left parietal lobe,left frontal lobe,right superior frontal gyrus,MNl coordinate:x=12?6?-39?-45?12,y=-36?54?-18?-18?6,z=78?-3?12?60?66;voxels:8589?622?346?464?157;t=-6.2086?-4.6238?-5.0948?-4.8746?-4.5463;FDR corrected p<0.05.When the frontal lobe(MNl coordinate:x=0,y=-27,z=69)was used as seed,compared to healthy group,reduced connectivities were observed in the left temporal lobe,right middle frontal gyrus,left parietal lobe,right superior frontal gyrus,right cingulate gyrus,MNl coordinate:x=18?39?-54?24?6,y=-51?45?-21?30?-21,z=9?-18?36?45?45;voxels:12536?99?510?77?104;t=-5.1981?-4.8179?-3.5712?-4.1543?-3.4971;FDR corrected p<0.05.Conclusions1.Brain gray matter and white matter volume were significantly reduce in CO-SZ.2.There are some abnormal functional connectivity of the brain regions in the resting state in CO-SZ patients.