精神分裂症患者脑结构及功能的多模态影像Meta分析

目的 研究在未用药物干扰前提下精神分裂症患者的脑结构及功能变化及两者之间的关系.方法 系统地从PubMed、Embase、Web of Science和The Cochrane Library数据库上检索相应文献.多模态分析方法采用软件"Seed-based d Mapping".结果 纳入14篇结构研究,包括446例患者和461例正常对照.纳入的15篇功能MRI及PET研究中,共有360例患者和396例正常对照.多模态结果分析表明结构和功能大部分重叠的脑区在额颞叶,双侧扣带回/扣带旁回,双侧岛叶,基底节及左侧小脑.结论 排除药物干扰后发现精神分裂症患者结构和功能重叠的脑区大部分在默认网络(DMN)和听觉网络(AN).在这2种网络中,结构和功能变化的方向不一致,可能反映了精神分裂症患者大脑不同的病理生理改变.

Structural and functional brain alterations in drug-free schizophrenia patients:a multimodal Meta-analysis

Objective By conducting a Meta-analysis on morphometric and functional imaging studies in drug-free patients,to examine the degree of overlap between anatomical and functional brain changes in schizophrenia.Methods A systematic search was conducted using PubMed,Embase,Web of Science and The Cochrane Library to identify relevant previous publications.A multimodal analysis was conducted using "Seed-based d Mapping"software.Results Fourteen structural MRI studies comprising 446 drug-free patients and 461 healthy controls,and 15 functional MRI and PET studies with 360 drug-free patients and 396 controls were enrolled in the present study. Multimodal analysis revealed considerable overlap between anatomical and functional changes,mainly in fronto-temporal regions,bilateral medial posterior cingulate/paracingulate gyrus,bilateral insula,basal ganglia,and left cerebellum.Conclusion The overlapping anatomical and functional brain abnormalities mainly in the default-mode network (DMN)and the auditory network (AN)in drug-free schizophrenia patients. The pattern of changes differed in these networks.Decreased gray matter was associated with decreased activation within the DMN, while decreased gray matter was associated with increased activation within the AN.These discrete patterns suggest different pathophysiological changes impacting structure/function relationships within different neural networks in schizophrenia.