Correlation Of Cognitive Function Characteristics And Brain Function In Schizophrenic Patients With Aggressive Behavior

Objective: Aggression in patients with schizophrenia is a serious public health problem,but the correlation between aggression and cognitive functioning is currently unclear.Imaging studies have found structural and functional impairments in schizophrenic patients with concomitant aggression,but the findings are mixed.Therefore,this study aimed to investigate the cognitive function characteristics of schizophrenic patients with aggression,as well as the alterations in brain structure and function from the perspective of neurocognitive function,and to provide an accurate scientific basis for the prediction and intervention of aggressive behavior in schizophrenic patients.Methods: Forty-four patients with schizophrenia and 31 healthy controls(HC)matched for general condition were recruited,and those with scores ≥5 based on the Mental Aggression Scale(MAOS)were defined as the aggressive group(N=22)and the rest as the non-aggressive group(N=22).All subjects completed general information collection as well as structural imaging and resting-state functional MRI scans.2 consistently trained investigators tested patients’ neurocognitive functioning using the Repetitive Battery of Neuropsychological Status(RBANS)and rated patients’ psychiatric symptoms using the Positive and Negative Symptom Scale(PANSS).Demographic and clinical data,RBANS scores were compared between the three groups in Experiment 1,and correlations between RBANS scores and MAOS score were analyzed for the attack group;Experiment 2 was measured by voxel-based morphometry(VBM)and amplitude of lowfrequency fluctuation(ALFF)based on frequency fluctuation(ALFF)method to correlate the gray matter volume and local brain function of the attack group with the speech function scale in RBANS.Results: Experiment 1:(1)There were no statistically significant differences in the demographic variables of age,gender and education level among the three study groups in this experiment.There was no statistically significant difference in the total PANSS negative and positive symptom scores between the aggressive and non-aggressive groups,but the duration of illness was shorter in the aggressive group than in the non-aggressive group(P < 0.05).(2)In RBANS test,there were significant differences in immediate memory,visual,verbal function,attention,and delayed memory scores among the assault group,non-assault group,and healthy control group(P < 0.001),and the verbal function scores of the non-assault group were significantly lower than those of the assault group(P < 0.05).(3)The scores of each dimension of the RBANS test in the aggression group were positively correlated with verbal function and self-aggression,with the absolute value of Spearman’s correlation coefficient >0.3.Experiment 2: The ALFF values of the right inferior temporal gyrus and right syrinx gyrus of patients in the aggression group were positively correlated with the speech function scores(P < 0.001),while no correlation was found with the gray matter volume and speech function scores of patients in the aggression group.Conclusion:(1)Schizophrenic patients with aggressive behavior had higher verbal function scores,and verbal cognitive function was associated with self-aggression.(2)Local abnormalities in the right inferior temporal gyrus and right cingulate gyrus of schizophrenic patients with aggressive behavior were associated with verbal cognitive function,suggesting a potential association between them.