The Correlations Between Brain Gray Matter Volume And Cognitive Function In First-episode Drug-naive Adolescents With Schizophrenia

Background Schizophrenia is a common and severe mental disorders,the etiology of complex and diverse,the specific pathogenesis has not yet clear,the schizophrenia of brain structure and functional imaging studies have made great progress.However,the clinical symptoms of adolescent schizophrenia patients are more serious,poor treatment,and prognosis is poor.Adolescents are at the peak of neurodevelopment,so at this stage of the patients most affected by neurov-developmental effects,so this study to the first drug-free adolescent schizophrenia(Adolescent-onset Schizophrenia,AOS)patients as the research object,and find discover the neuropath logical basis of cognitive impairment in schizophrenic patients.Objective Through the study of the cognitive function and psychiatric symptoms of adolescents with first-episode schizophrenia,the VBM method was used to analyze the gray matter volume of the local brain regions,and further analysis of cognitive test scores,PANSS scores and local brain areas Gray matter volume,and explore the relationship between the gray matter volume and cognitive function and psychiatric symptoms in adolescent schizophrenia.Method A total of 35 patients with newly diagnosed AOS were admitted to hospital in the psychiatric department of the Second Affiliated Hospital of Xinxiang Medical College from April,2015 to June,2016.The subjects were matched for sex,age,right-hander and years of education.Of the 35 local community volunteers as a normal control group,The scores of cognitive function test,and functional magnetic resonance imaging(f MRI)wereused to evaluate the cognitive function of the two groups,the patients were assessed by PANSS.The cognitive function tests included Trail Making Test(Part A,TMTA)(BVMT-R),maze test,category fluency test,Stroop color-word test,continuous operation(B-mode),Coding(Symbol Coding),Hopkins Vocabulary Learning Test-Revised(HVLT-R),Simple Visual Memory Test-(CPT)and spatial span subspecies(SSS).The gray matter volume of the two groups was compared and analyzed by VBM method.The difference of cognitive scores and PANSS scores between the two groups was compared.Further analysis was made of the correlation between the scores of PANSS and the score of PANSS,the correlation between the gray matter volume of local brain area and the score of PANSS.In addition,the patient group after antipsychotic treatment 2 months after follow-up observation,cognitive test scores before and after treatment,PANSS scores and regional brain gray matter volume were compared and analyzed.Results1.There was no significant difference in the general data such as age,sex and years of educated between the two groups,there was no significant difference between the two groups(P> 0.05).2.In addition to the fluency of the category,the differences dimensions between the two groups were statistically significant(P <0.05),compared with before treatment,TMTA,HVLT-R and CPT had statistically significant differences(P <0.05)between the two groups before and after treatment,there was no significant difference in cognitive performance(P> 0.05).3.There were significant differences in the scores of PANSS before and after treatment(P<0.05);there was no correlation between the scores of PANSS and cognitive tests before treatment(P> 0.05).There was a negative correlation between the HVLT-R test scores and the negative symptom scores(r =-0.549,P = 0.012);there was a negative correlation between category fluency animal naming and general pathological score(r =-0.497,P =0.026),the rest have no correlation.4.The volume of gray matter in the left frontal gyrus,left parietal lobule and parietal lobule were significantly lower than those in the normal control group(P <0.05);there was no significant difference in gray matter volume between the two groups before and after treatment(P> 0.05);in the study group,the uncorrected P <0.001 was used as the test level,and the threshold was 10 pixels.5.The volume of left upper frontal gray matter was negatively correlated with the code number(r =-0.42,P <0.05)before treatment;There was a positive correlation between TMTA(r = 0.37,P <0.05)and the left lobulart gray matter volume,there was a negative correlation between the volume of the gray matter on the top of the left side and the symbolic coding(r =-0.41,P <0.05).There was a positive correlation between the volume of gray matter in the top and bottom leaves and the TMTA(r = 0.46,P <0.05);there was a negative correlation between the volume of gray matter in the top and bottom leaves of the left side and ST-3 test(r=-0.40,P<0.05),maze test(r=-0.38,P<0.05),CPT(r=-0.39,P<0.05),Spatial span subtes(r =-0.38,P <0.05).There was a positive correlation between the right anterior central gray matter volume and TMTA(r = 0.38,P <0.05);There was a negative correlation between the right anterior central gray matter volume and ST-1(r =-0.39,P <0.05)and maze test(r =-0.46,P <0.05).6.The positive symptom score of the patients was positively correlated with the left parietal lobes(r = 0.423,P = 0.020);score of sexual symptoms was positively correlated with the left prefrontal lobe(r = 0.413,P = 0.023);there was a positive correlation between the general pathological score and the parietal lobule(r = 0.414,P = 0.023);the PANSS score was positively correlated with left side of the top leaflet(r=0.417,P=0.022)and the left prefrontal cortex(r = 0.464,P = 0.010);the rest did not find correlation(P>0.05).Conclusion1.Early onset schizophrenia patients have existenced a wide range of cognitive impairment in the early stages,and cognitive impairment and positive symptoms,negativesymptoms tied to the third group of symptoms of schizophrenia.After treatment,the characteristics of cognitive impairment is independent of the negative symptoms gradually disappear.2.In patients with early-onset schizophrenia,there were abnormalities in local gray matter volume.3.The cognitive impairment of early-onset schizophrenia patients may be closely related to the abnormal changes of local gray matter volume,structural changes in the brain may be the basis of cognitive impairment in neuropathology,this further supports the neurodevelopmental disorders of schizophrenia.