| Objective: To explore the cognitive insight impairment and the aberrant function connectivity within default mode network in first-episode adolescent schizophrenic patients,as well as the internal relations.Methods : 21first-episode adolescent schizophrenic patients was selected who admitted in the third hospital of Mianyang during December 2016 to December 2017,were assessed with the Scale for Assessment of Positive Symptoms(SAPS),Scale for Assessment of Negative Symptom(SANS),the Beck Cognitive Insight Scale(BCIS),and Psychotic Symptom Rating Scales(PSYRAT)at the baseline;21 age,gender,education year matched healthy volunteers were recruited through advertising,all of them were assessed with the Beck Cognitive Insight Scale.All of the patients and health controls were underwent resting-state functional magnetic resonance image(fMRI)scan using the Seaman 3T magnetic resonance imaging systerm.The fmri data were pre-processed through slice-timing,head movement correction,normalization and smoothing,then GIFT was used to perform the independent component analysis(ICA),find the optimal matching component for default mode network(DMN).Two sample T-test was used to find the differences of function connection in DMN between patients and health controls.Extracted the Z value of those different areas,and the clinical data were analyzed by Canonical correlation analysis.Statistic analysis of clinical data and fmri data was operated by SPSS,demographic data were analyzed with chi-square tests,one-sample t test was used in between-group,relativity analysis was performed by Pearson correlation analysis and Spearman correlation analysis,the results were statistically significant while P<0.05.Results:1.There is no significant statistical deviation in age,gender and education year(P<0.05).The self-certainty(SC)score of BCIS in patients was significant higher than the controls(t=2.15,P<0.05),Pearson correlation analysis showed that the self-reflectiveness(SR)score was negative related with SAPS score(r=-0.565,P<0.05),the SC score was negative related with the SANS score(r=-0.471,P<0.05),and there is no significant correlation between SR score,SC score,composite index(CI)and age,education year,duration,PSYRAT(P>0.05).2.Differences in brain area were produced through two-sample t test,include left superior frontal gyrus(t=3.359),ventromedial prefrontal cortex(t=-3.748),left middle temporal gyrus(t=-3.975),right anterior cingulate(t=-5.008),right posterior cingulate(t= t=3.336),left medial frontal gyrus(t=-3.263),right medial frontal gyrus(t=-3.695),right caudate nucleus(t=5.347)and left caudate nucleus(t=3.886).3.The SC score was positive related with the function connection in right medial frontal gyrus(r=0.482,P<0.05),the SAPS score was negative related with the function connection in ventromedial prefrontal corte(VLPFC)(r=-0.508,P<0.05).Conclusion:1.There is a significant cognitive insight impairment in first-episode adolescent schizophrenic patients,mainly manifest as overconfident in judgment.Patients with more positive symptoms were less able to introspect,who had more negative symptoms were less self-affirming.2.The DMN show differences between patients and health controls in left superior frontal gyrus,ventromedial prefrontal cortex,left middle temporal gyrus,right anterior cingulate,right posterior cingulate,left medial frontal gyrus,right medial frontal gyrus and bilateral caudate nucleus,and the higher function connection in right medial frontal gyrus the stronger self convince will have,the patients with lower function connective in ventromedial prefrontal cortex tend to have serious positive sympton. |
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