A Comparative Study Of Resting-state Function MRI And 3D ASL In Schizophrenia Patients Of Different Subtype

Part 1 A comparative study of resting-state function MRI in schizophrenia patients of different subtypeObjects:To investigate the difference of ReHo between patients with schizophrenia of different subtype and control groups by using the method resting state function MRI.Besides,the role of differential area were also discussed.Results of our study can provide a imaging basis for further study about the pathogenesis and classification of schizophrenia.Material and method:1.Subjects:Patients were diagnosed with Diagnostic and Statistical Manual of mental disorders?DSM-V?,fifth edition of American psychiatric.Schizophrenia patients were divided into positive group?n=25?and negative group?n= 19?according to the PANSS scale.Twenty healthy volunteers with matched age,gender and year of education were selected as the control group.2.Data acquisition:High resolution structural images and resting-state fMRI data were performed using GE Signa HDXT 3.OT.Besides,conventional sequence such as T1WI,T2WI and FLAIR imaging were also acquired.3.Data preprocessing:DPASFA 2.3,which based on the MATLAB?R2012a?was applied to data preprocessing.The preprocessing step of ReHo including format conversion,removal of the first 10 time points,slice timing,realign,normalization,detrend,filter and regression out covariates,calculate ReHo value and smooth.In realign step,those subjects whose head movements exceed 2mm maximum displacement and 2 ° maximum rotation in the direction of x,y,z were excluded.4.Statistical analysis:The differences of age,gender and educational years between the three groups were compared by SPSS 20.0 and P<0.05 was considered statistically significantly.One way ANOVA in REST was used to compare the ReHo among the three groups?AlphaSim corrected,P<0.01?.Extract the ReHo where differences exist and save as a mask.Afterward,a post hoc test was performed for the comparison of patients and control group?Bonferroni corrected?.Differences was deemed statistically significantly when P<0.05.Results:There shows no significant differences in age,gender and education years between schizophrenia subgroups and control group.Compared with the controls,positive group shows significantly decreased ReHo in the right orbital superior frontal gyrus,middle temporal gyrus.Besides,ReHo were significantly increased in the right putamen,left inferior occipital cortex and bilateral lingual gyrus.While compared with the controls,negative group shows increased ReHo in cerebelum₈L,left inferior temporal gyrus,right putamen.ReHo were significantly decreased in the right orbital superior frontal gyrus and left postcentral gyrus.Conclusion:Compared with the control group,there were extensive ReHo changes in positive and negative symptom profile schizophrenia including the frontal lobe,temporal lobe,occipital lobe,basal ganglia and cerebellum etc.Besides,ReHo changed area of positive group and the negative group were different.So it is inferred that there may be different neuropathological differences in schizophrenia patients of different subtypes.The results of our series shows that the function abnormalities of frontal lobe and putamen may be a common pathological change of schizophrenia,and occipital lobe may related to the positive symptoms.Besides,cerebellum may be associated with the pathogenesis of negative symptoms.The role of temporal subregion and postcentral gyrus in the pathogenesis of schizophrenia is not clear yet.Part 2 A comparative study of cerebral blood flow in schizophrenia patients of different subtype with three-dimensional arterial spin labelingObjects:SPECT and PET/CT studies indicated that schizophrenia patients have differences in cerebral blood flow.3D ASL was used to detect the changes of cerebral blood flow in positive and negative symptom profile schizophrenia patients.Perfusion characteristics of different subtypes schizophrenia patients were investigated noninvasively.Besides,the role of above brain regions in schizophrenia patients were also discussed.Material and Methods:1.Subjects:Patients were diagnosed with Diagnostic and Statistical Manual of mental disorders?DSM-V?,fifth edition of American psychiatric.Schizophrenia patients were divided into positive group?n=25?and negative group?n=19?according to the PANSS scale.Twenty healthy volunteers with matched age,gender and year of education were selected as the control group.2.Data acquisition:High resolution structural images and three-dimensional pseudo-continues arterial spins imaging?3D ASL?were performed using GE Signa HDXT 3.0T.Besides,conventional sequence such as T1WI,T2WI and FLAIR imaging were also acquired.3.Data preprocessing:The cerebral blood flow?CBF?map of the subjects was obtained from the Functool post-processing workstation of GE Signa HDXT 3.0T scanner.Statistical parametric mapping?SPM?was used to preprocess the CBF maps including format conversion,coregistration,segment,normalization and smooth.4.Statistical analysis:The differences of age,gender and educational years between the three groups were compared by SPSS 20.0 and P<0.05 was deemed significantly.One way ANOVA analysis was performed to compare the CBF differences among the three groups?P<0.05?.Afterwards,those cluster size which greater than 56 voxel were extract as a mask.A two-sample t-test was used to compare the CBF of patients and control group?AlphaSim corrected,P<0.05?.Results:There was no significant differences for age,gender and education years between three groups.Compared with the controls,positive group showed increased CBF in the right inferior,middle occipital,left temporal gyrus and decreased CBF in the left thalamus,bilateral superior frontal gyrus.In the negative group,the CBF of left middle temporal gyrus,inferior and middle occipital gyrus,angular gyrus were significantly increased.While CBF of the left putamen,thalamus,precuneus,right caudatum,supplemental motor area and bilateral superior frontal gyrus were significantly decreased.Conclusion:Firstly,the study demonstrated that arterial spins labeling as a non-invasive MR technique,can be used to detect cerebral blood flow in schizophrenia patients.Besides,the study also supported the finding of PET/CT and SPECT about the perfusion abnormalities of frontal,temporal lobe,occipital lobe and basal ganglia etc..Cerebral blood flow were significantly changed in subtype schizophrenia patients.It suggesting that positive and negative symptom profile schizophrenia may be different in pathphysiologic since the CBF differ in three groups.Perfusion changes in different regions of the negative and positive groups may be related to the clinical manifestations of different subtypes of schizophrenia.Such as a change in the perfusion of the frontal lobe,thalamus could be a common physiological changes of schizophrenia.Precuneus and angular gyrus may have a certain relationship with the occurrence of negative symptoms.The roles of supplemental motor area in the pathogenesis of schizophrenia need to be further confirmed.