精神分裂症谱系的阴性症状与社会功能和静息态脑功能的相关研究
文献类型：学位论文
| 作者 | 胡慧欣 |
| 答辩日期 | 2023-06 |
| 文献子类 | 博士 |
| 授予单位 | 中国科学院大学 |
| 授予地点 | 中国科学院心理研究所 |
| 其他责任者 | 陈楚侨 |
| 关键词 | 精神分裂症谱系 阴性症状 动机愉快感缺损能 社会功能 静息态脑功能 |
| 学位名称 | 理学博士 |
| 学位专业 | 认知神经科学 |
| 其他题名 | Associations of Negative Symptoms with Social Functioning and Resting-state Functional Connectivity in Schizophrenia Spectrum Disorders |
| 中文摘要 | Negative symptoms are commonly found in patients with schizophrenia (SCZ) spectrum disorders. Recent findings suggest negative symptoms are not unitary construct but a 2一facet construct comprising the Motivation and Pleasure (MAP) deficit, and the Expressivity (EXP) deficit. These two factors may have distinct behavioural and neural manifestations. Social functioning, on the other hand, is an important long-term prognostic goal in the treatment of mental illness, and the severity of negative symptoms have been consistently found to strongly determine SCZ patients' levels of social functioning. However, most of the previous studies investigating the relationship between negative symptoms and social functioning were limited to a unitary construct of negative symptoms. It is still unclear how the MAP and EXP factors may affect social functioning in SCZ patients and individuals with high level of social anhedonia. Similarly, limited empirical findings based on a unitary construct of negative symptoms suggest that negative symptoms are correlated with cortico-striatal resting-state functional connectivity (rs-FC). It remains unclear whether the MAP and EXP factors of negative symptoms may correlate distinctively with the altered cortico-striatal rs-FC as well as the whole-brain rs-FC in patients with SCZ and individuals with high level of social anhedonia. To bridge such a gap of knowledge, this dissertation adopted a two-factor structure of negative symptoms to examine the relationship between MAP and EXP factors with social functioning and rs-FC in both patients with SCZ and individuals with high level social anhedonia. Study 1 examined the overall interaction pattern of MAP and EXP deficits and social functioning in 269 SCZ patients using network analysis and relative importance contribution analyses. The Clinical Assessment Interview for Negative Symptoms (CAWS) was adopted to capture the MAP and EXP factors of negative symptoms. Results showed that the MAP deficit, rather than the EXP deficit, was closely related to social functioning in SCZ patients. Network centrality estimates and relative importance analysis showed that MAP deficit played the central role in the network and accounted for the largest proportion of variance of social functioning. These findings suggested that the pivotal role of the MAP deficit to determine SCZ patients' social functioning. Study 2 examined the overall interactions between MAP and EXP factors and social functioning in 2889 college students using network analysis. Results showed that the reduction in motivation factor showed close and negative connection with social functioning. Network centrality estimates showed that motivation factor played a relatively central role in the network. The relative importance analysis further showed motivation factor explaining larger proportion of variance of social functioning. Study 3 examined the relationships between the MAP and EXP deficits and the altered rs-FC in 73 patients with SCZ based on CAWS, we also recruited 28 controls for rs-FC comparison. Results showed that, compared to healthy controls, SCZ patients exhibited altered rs-FC of the bilaterally dorsal striatum and cortical areas (mainly involving the left anterior cingulate gyros, superior frontal gyros, cuneus, superior temporal gyros and middle temporal gyros). Hyper-connectivity of the right dorsal striatum and left anterior cingulate gyros (ACC) was positively correlated with MAP deficits in SCZ patients. We did not find significant correlation between rs-FC and EXP deficits. The whole-brain graphical analysis showed that the MAP deficits were positively correlated with the rs-FC of the right thalamus and left precentral gyros, the rs-FC of right caudate and left superior temporal gyros, whereas the MAP deficits were positively correlated with the rs-FC of the right putamen and temporal pole. The findings of MAP deficits correlating with the rs-FC of the right dorsal striatum and left ACC were replicated in an independent sample of 51 SCZ patients and 49 controls. Study 4 further examined the relationships between the MAP and EXP deficits and the altered rs-FC in 42 participants with high level of social anhedonia and 53 participants with low level of anhedonia. Results showed that, compared to participants with low level of anhedonia, participants with high level of social anhedonia exhibited altered rs-FC of the right dorsal striatum and cortical areas (mainly involving the inferior parietal gyros, superior temporal gyros and middle temporal gyros). We did not find significant correlation between MAP and EXP deficits and the altered cortico-striatal rs-FC in both pariticpants with high and low levels of social anhedonia. Taken together, the present findings suggest the important role of the MAP factor to determine social functioning in both SCZ patients and individuals with high level of social anhedonia. Our findings also suggest that MAP deficits shown in SCZ patients are specifically correlated with the rs-FC of the right dorsal striatum and left ACC. These all highlight MAP deficit and its associated rs-FC may be potential biomarkers for SCZ, and provide important implications for the intervention development. |
| 英文摘要 | 阴性症状普遍存在于精神分裂症谱系群体中。近来研究表明，阴性症状至少可区分为两个维度，即动机愉快感缺损和表达缺损，且这两个维度被认为与不同的行为表现以及静息态脑功能相关。社会功能是精神疾病治疗过程中一个非常重要的长期预后目标，而阴性症状被发现与社会功能紧密相关，但过往针对阴性症状与社会功能关系的研究往往局限于阴性症状的单一症状维度。尚不清楚临床精神分裂症患者与非临床群体阴性症状的动机愉快感缺损、表达缺损和社会功能的整体相关模式。此外，已有少数研究提示，阴性症状与皮层一纹状体功能连接的异常有关，而这些研究也仍旧局限于阴性症状的单一症状维度。目前尚不清楚临床患者和亚临床高社会快感缺失个体阴性症状的动机愉快感缺损、表达缺损与皮层一纹状体功能连接、以及全脑网络特征和功能连接的潜在联系。 为探究上述问题，本论文基于阴性症状的两因素结构，在行为层面探究了临床精神分裂症患者与非临床群体动机愉快感缺损、表达缺损和社会功能的关系特点;在静息态脑功能层面探究了临床精神分裂症患者和高社会快感缺失个体阴性症状两个维度潜在相关的静息态脑功能。 研究一采用网络分析和相对重要性分析，考察了269名临床精神分裂症患者动机愉快感缺损、表达缺损与社会功能的整体相关模式。采用第二代的阴性症状临床评估工具(Clinical Assessment Interview for Negative Symptoms, CAWS)评估患者的动机愉快感缺损和表达缺损。网络分析的结果发现，临床精神分裂症患者的社会功能与动机愉快感缺损存在更为紧密的连接，而与表达缺损的连接较为疏远。网络中心性估计和相对重要性分析的结果发现，动机愉快感缺损在网络中处于较为中心的位置且能解释更大比例的社会功能变异。上述结果均强调了动机愉快感缺损对临床精神分裂症患者社会功能的关键作用。 研究二进一步探究了2889名非临床大学生群体的动机愉快感、情绪表达两方面与社会功能的整体相关模式。网络分析的结果发现，动机因子与社会功能之间存在更为紧密的负相关;网络中心性估计表明，动机因子在网络中处于相对中心的位置。且相对重要性分析进一步表明，动机因子能解释更大比例的社会功能变异。 研究三招募73名临床精神分裂症患者和28名对照，考察临床患者潜在异常的静息态脑功能连接，及其与患者CAWS量表的动机愉快感缺损、表达缺损的潜在关系。结果发现，临床精神分裂症患者主要表现出双侧背侧纹状体与皮层区域(涉及前扣带回、额上回、楔叶、颗上回、颗中回)之间功能连接的异常;且右侧背侧壳核一前扣带回之间增强的功能连接与CAWS动机愉快感缺损呈显著正相关，但未发现与表达缺损相关的皮层一纹状体功能连接。另一方面，基于全脑图论分析的结果发现，临床患者的右侧丘脑一左侧中央前回功能连接、右侧尾状核一左侧颗上回功能连接与CAWS动机愉快感缺损呈显著正相关;右侧壳核一右侧颗极的功能连接与CAWS表达缺损呈显著正相关。右侧背侧壳核一前扣带回功能连接与动机愉快感缺损的相关关系在包含51名精神分裂症患者和49名对照的验证样本中得到了验证。 研究四进一步考察了42名高社会快感缺失个体和53名对照动机愉快感缺损、表达缺损与异常的静息态脑功能连接的关系。结果表明，亚临床高社会快感缺失个体已表现出右侧背侧纹状体与皮层区域(主要涉及顶下回、颗上回、颗中回)功能连接的改变，但在高社会快感缺失个体中并未发现与 CAWS动机愉快感缺损、表达缺损相关的静息态功能连接。 综上所述，本论文发现了，动机愉快感缺损在决定精神分裂症谱系群体社会功能中的重要作用，此外，在临床患者中还发现了动机愉快感缺损与背侧纹状体一前扣带回功能连接之间独特的联系。这些研究结果提示，动机愉快感缺损及其相关的静息态功能连接可能是精神分裂症患者的潜在生物标志物，这为治疗干预方案的开发提供了重要的参考。 |
| 语种 | 中文 |
| 源URL | [http://ir.psych.ac.cn/handle/311026/46158]  |
| 专题 | 心理研究所_健康与遗传心理学研究室 |
| 推荐引用方式 GB/T 7714 | 胡慧欣. 精神分裂症谱系的阴性症状与社会功能和静息态脑功能的相关研究[D]. 中国科学院心理研究所. 中国科学院大学. 2023. |
入库方式： OAI收割
来源：心理研究所
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