A Study Of Cognitive Impairment And Characteristics Of White Matter Microstructure In Early-onset Schizophrenia

Objective:Schizophrenia is recognized as a complex chronic severe mental disorder.One of its core symptoms is multiple cognitive impairment.However,the characteristics of neurocognitive impairment,the neuropathological mechanism of the disease,and the relationship between cognitive impairment and clinical phenotype data are still unclear.One of the dominant views is the disconnection hypothesis of schizophrenia,which states that many symptoms of schizophrenia are related to abnormal connections between different brain regions involving white matter lesions in the brain.Early-Onset Schizophrenia(EOS)has unique advantages in studying its pathogenesis due to its sensitive neurodevelopmental period,high genetic load,and low influence of environmental and social factors.In this study,patients with early-onset schizophrenia were selected as the research objects.Based on neurocognitive test and diffusion tensor imaging technology,we explored the characteristics of cognitive impairment and brain structural changes,and analyzed the relationship between cognitive function and brain structural abnormalities and clinical phenotypic data,so as to provide reference for early detection,personalized diagnosis and early intervention of the disease.Methods:A total of 48 subjects were included in this study,including 18 patients with Early-Onset Schizophrenia(EOS)and 30 normal controls.General demographic data,clinical phenotypic data,neurocognitive function data and diffusion tensor imaging data were collected for all subjects participating in the study.Age and years of education were compared between the two groups of subjects using the t-test,and gender differences were compared between the two groups using the corrected chi-square test.Two independent samples t-tests were used to compare the cognitive scores of the two groups on the MATRICS Consensus Cognition Battery(Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognition Battery,MCCB).The fractional anisotropy(FA)values of the corrected fractional brain structures were extracted from the corrected fractional brain structures by using the Tract-based spatial statistic(TBSS)method to analyze the differences in fractional brain structures.)values were correlated with clinical phenotype data and each neurocognitive function index score by Pearson correlation analysis;clinical phenotype data were correlated with each neurocognitive domain index score by Pearson correlation analysis.To explore the characteristics of cognitive impairment and structural brain changes in EOS,and to analyze the relationship between cognitive function and abnormal brain areas and clinical phenotypic data.Results:1.Intergroup comparison of neurocognitive function: The EOS group and the normal control(Healthy control,HC)group had statistically significant differences in five neurocognitive domains including information processing speed(P<0.001),attention/alertness(P<0.001),working memory(P=0.002),visual memory and learning(P=0.019),and reasoning and problem solving(P<0.001)were statistically significant,with the EOS group scoring significantly lower than the HC group in five cognitive domains: information processing speed,attention/alertness,working memory,visual memory and learning,and reasoning and problem solving.There was no statistically significant difference between the two groups in the cognitive domains of word memory and learning(P=0.089).2.Results of structural analysis of white matter fiber tracts: compared with the HC group,the EOS group had significantly lower FA values in the frontal part of the left corpus callosum radiation,and no brain areas with increased FA values were seen.3.Correlation analysis between neurocognitive function and clinical phenotypic data: The results of Pearson correlation analysis showed that the EOS group was associated with positive and negative symptoms scale(PANSS)total score(r=-607,P=0.008),positive symptoms scale score(r=-0.471,P=0.048),and negative symptoms scale score(r=-0.485,P=0.041)in terms of information processing speed and general psychopathology scale score(r=-0.589,P=0.010).Rreasoning and problem solving were negatively correlated with negative symptoms scale score(r=-0.519,P=0.027);no significant correlations were found for the remaining aspects.Conclusion:This study found a correlation between the characteristics of cognitive impairment present in patients with EOS and alterations in abnormal fiber tracts in the white matter of the brain,and indicators of cognitive function and clinical phenotype.patients with EOS had significant impairments in the following five cognitive dimensions of function:processing speed,attention/alertness,working memory,visual memory and learning,and reasoning and problem solving;in terms of brain structure,there was one fiber tract with significant differences for the frontal part of the corpus callosum radiation,which showed a reduction in FA values.information processing speed in EOS patients was negatively correlated with the severity of psychotic symptoms,and reasoning and problem solving indicators were negatively correlated with negative symptom scale scores.The results of this study provide new insights into the understanding of the pattern of cognitive impairment and neuropathological mechanisms in EOS,and the relationship between cognitive impairment characteristics and clinical phenotypic information.