| BackgroundSchizophrenia is a destructive and disabling neuropsychiatric disorder.Schizophrenia is a highly heterogeneous disease.The younger the onset age,the higher the genetic risk,the more atypical the symptoms,the more serious the cognitive impairment,and the worse the treatment effect and prognosis.Children’s schizophrenia is usually referred to as children’s schizophrenia when they are younger than or equal to 13 years old.Children’s schizophrenia or children’s schizophrenia are called juvenile schizophrenia when they are14 to 18 years old.Some scholars regard children’s schizophrenia or children’s Schizophrenia.Up to now,the etiology and pathogenesis of the disease are still unclear.More and more studies have shown that the pathogenesis of the disease may be related to neurodevelopmental abnormalities.In recent years,structural and functional magnetic resonance studies have found differences in many brain regions,such as frontal lobe,temporal lobe,parietal lobe,occipital lobe,anterior central gyrus,cingulate gyrus,lingual gyrus and caudate nucleus(compared with healthy controls).There are also reports on the comparison of brain structure and brain function between schizophrenic patients with auditory hallucination and schizophrenic patients without auditory hallucination,but there are few reports on schizophrenic children and adolescents with auditory hallucination.In the past,we studied the brain structure and function of case group and control group,and found that there were abnormalities in many brain regions,which indicated that schizophrenia in children and adolescents was The pathogenesis may be related to abnormal brain structure and function.In this study,resting magnetic resonance imaging(MRI)was used to compare the structural and functional differences between first-episodeschizophrenia with and without hallucination in children and adolescents,and to explore the neuroimaging mechanism of hallucination.Objectives1.Compare the difference of gray matter volume between children and adolescents with first episode schizophrenia without auditory hallucination.2.To compare the characteristics of low-frequency amplitude and local consistency of brain in resting children and adolescents with first episode schizophrenia without auditory hallucination,and to explore the neuroimaging mechanism of auditory hallucination.MethodsA total of 84 children and adolescents with schizophrenia in accordance with Diagnostic and Statistical Manual of Mental Disorders-IV(DSM-IV)were enrolled as the study subjects.34 healthy people matched with patients in terms of gender,age and years of education were used as the control group.The volume,low-frequency amplitude and local consistency of gray matter in resting state were obtained by 3.0T magnetic resonance scanning in voxels.The positive symptoms were assessed by two psychiatrists who were in charge of psychiatry for children and adolescents and above before taking medicine.The patients were divided into hallucination group and non-hallucination group according to the "auditory hallucination" score(≥3)in the positive symptoms scale and(≤2)in the non-hallucination group.The differences of gray matter volume,low frequency amplitude and local consistency between auditory hallucination group,non-auditory hallucination group and control group were compared by independent sample T test.Results1.Comparisons of gray matter volume(1)Compared with the healthy control group,the volume of gray matter in the left marginal lobe,anterior central gyrus,right spindle gyrus,right temporal lobe,left caudatenucleus,right frontal lobe and cingulate gyrus of the auditory hallucination group was significantly reduced;the difference was statistically significant,with Alphasim correction P < 0.05.(2)Compared with the healthy control group,the volume of gray matter in the left frontal lobe,right temporal lobe,right occipital lobe,left marginal lobe,cingulate gyrus and left fusiform gyrus of the brain in the non-auditory hallucination group was significantly reduced;the difference was statistically significant,with Alphasim correction,P < 0.05.(3)Compared with non-auditory hallucination group,the volume of gray matter in left frontal lobe and anterior central gyrus of the brain in auditory hallucination group increased significantly;the difference was statistically significant,Alphasim corrected,P <0.05.2.Comparison of Amplitude of Low-Frequency Fluctuation(1)Compared with the healthy control group,the brain regions with lower low frequency amplitude in auditory hallucination group were right frontal lobe,left temporal lobe,parietal lobe and central anterior gyrus,and the brain regions with higher low frequency amplitude had cingulate gyrus;the difference was statistically significant,Alphasim corrected,P < 0.05.(2)Compared with healthy control group,non-hallucination group had lower low-frequency amplitude in the right occipital lobe,left temporal lobe and left superior frontal gyrus,and higher low-frequency amplitude in the left middle frontal gyrus,cingulate gyrus and right marginal lobe;the difference was statistically significant,Alphasim corrected,P < 0.05.(3)Compared with the non-auditory hallucination group,the right frontal lobe was found in the brain area of the auditory hallucination group with lower low-frequency amplitude,and the difference was statistically significant,Alphasim corrected,P < 0.05.3.Comparison of Regional Homogeneity(1)Compared with the healthy control group,the brain areas with decreased local consistency in auditory hallucination group included right superior frontal gyrus,left inferior frontal gyrus,central anterior gyrus,left paracentral lobule and left anterior cuneate lobe.The difference was statistically significant,with Alphasim correction P <0.05.(2)Compared with healthy control group,non-hallucination group had lower local consistency in the right frontal lobe,right temporal lobe,parietal lobe and central anterior gyrus,and higher local consistency in the left occipital lobe;the difference was statistically significant,Alphasim correction,P < 0.05.(3)Compared with the non-auditory hallucination group,the right anterior wedge lobe was found in the brain region with decreased local consistency in the auditory hallucination group,and the difference was statistically significant,Alphasim corrected,P< 0.05.Conclusions1.The first episode of schizophrenia in children and adolescents with or without auditory hallucinations had multiple loss of brain gray matter volume;the frontal lobe and anterior central gyrus gray matter volume in children and adolescents with auditory hallucinations were significantly reduced compared with those without auditory hallucinations.2.In resting state,the first episode of schizophrenia in children and adolescents with or without auditory hallucination had abnormal spontaneous nervous activity in many brain regions;compared with non-auditory hallucination group,the patients with auditory hallucination had abnormal spontaneous nervous activity especially in frontal lobe and anterior cuneate lobe,suggesting that the frontal lobe and anterior cuneate lobe played a significant role in the pathophysiological mechanism of auditory. |
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