| Objectives To evaluate the cognitive deficits as well as to explore the characteristics of functional areas of verbal fluency and backward digit span tasks by using blood oxygenation level dependent functional magnetic resonance imaging(BOLD-fMRI) in first-episode schizophrenic patients before and after antipsychotic drugs treatment.Methods 60 first-episode drug-naive schizophrenic patients diagnosed with ICD-10 were randomly assigned to I (n=30) and II(n=30) groups, and received the treatment of risperidone(3~6mg/d) or chlorpromazine(300~600mg/d) respectively. The total score and subscores on Wechsler adult intelligence scale-revised in china(WAIS-RC) and Wechsi.er memory scale(WMS) were obtained for all the patients pre and post-treatments,and the patients were also assessed by the Positive and Negative Syndrome Scale(PANSS) and Treatment Emergent Symptoms Scale(TESS). Before the treatment, I A subgroup(18 cases of I group) and II A subgroup(18 cases of II group) all underwent the fMRI while performing a verbal fluency task(VF) and backward digit span task(BDST), and after the treatment of risperidone or chlorpromazine, 16 patients among the I A subdroup and 15 patients among the IIA subgroup repeated the fMRI examination, moreover, 18 healthy volunteers also finished the fMRI scanning while performing a verbal fluency task or backward digit span task. A block-design paradigm with 6 blocks was applied and the functional image were obtained using gradient echo planar imaging(EPI), then the data of anatomical and functional images were co-registered with an workstation and the activation map was obtained. Results (1) The Memory Quotient(92.29 + 17. 15), performance intelligence Quotient (96. 40?1. 20) and part items of WMS and WAIS-RC in first-epsode drug-naive schizophrenic patients were significantly lower than the mean level of common people(P<0.05 or 0.01). (2) Withpaired-samples t test, the differences of MQ, PIQ and part items of WMS and WAIS-RC between pre- and post-treatment in group I and group II were significant(P<0. 05 or 0.01), and most scores increased greatly with the improvement of symptoms. With the analysis of covariance, the differences between group I and groupII were not significant(P>0. 05). (3) during the VF task, healthy volunteers showed significant activations in bilateral superior frontal gyrus, middle frontal gyrus, right inferior frontal gyms and right anterior cingulate, and patients with schizophrenia showed less activations in bilateral middle frontal gyrus, inferior frontal gyrus and anterior cinguiete. during the BDST task, areas showing activation in healthy volunteers include bilateral middle frontal gyrus, left superior frontal gyrus, inferior frontal gyrus, precentral gyrus, superior parietal lobe, suprarnarginal gyrus, Inferior temporal gyrus and occipitotemporalis lateralis gyrus, however, the left superior frontal gyrus, inferior frontal gyrus and bilateral posterior parietal cortex in schizophrenic patients showed significantly less activation. (4) Compared with that of the pre-treatment, the activation map of post-treatment schizophrenic patients is significantly different. During the VF task, the post"treatment signal intensity of subgroup I A in right superior frontal gyrus, superior parietal lobe and left occipitotemporalis lateralis gyrus were significantly greater than the pre-treatment signal intensity ( P<0.05 ) , however,the post-treatment signal intensity of subgroup IIA in right middle frontal gyrus and left inferior temporal gyrus decreased significantly (P<0.05}. During the BDST task, the hypo-activation of subgroup I A in left, superior frontal gyrus and left inferior frontal gyrus improved greatly(P<0. 05), and the hypoactivation of subgroupIIA in left superior frontal gyrus and left inferior frontal gyrus also improved greatly (P<0.05) , but the post-treatment signal intensity of subgroup IIA in right inferior temporal gyrus decreased significantly (P<0, 05)Conclusions (1) This finding surport that the cognitive deficits are the core fe...
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