Relationships between abnormal neural activities and cognitive impairments in patients with drug-naive first-episode schizophrenia.

BACKGROUND: Prior resting state functional Magnetic Resonance Imaging studies (rs-fMRI) via the regional homogeneity (ReHo) method have demonstrated inconsistent and conflicting results because of several confounding factors, such as small sample size, medicinal influence, and illness duration. Relationships between ReHo measures and cognitive impairments in patients with drug-naive First-Episode Schizophrenia (dn-FES) are rarely reported. This study was conducted to explore the correlations between ReHo measures and cognitive deficits and clinical symptoms in patients with dn-FES. METHODS: A total of 69 patients with dn-FES and 74 healthy controls were recruited. MATRICS Consensus Cognitive Battery (MCCB), Wechsler Adult Intelligence Scale (WAIS), and Positive And Negative Syndrome Scale (PANSS) were used to assess cognitive function, Intelligence Quotient (IQ), and clinical symptoms, respectively. The correlations between ReHo maps and cognitive deficits and the severity of symptoms were examined using strict correlation analysis. RESULTS: ReHo values in right Middle Frontal Gyrus (MFG) and Superior Frontal Gyrus (SFG) increased in dn-FES group, whereas ReHo values in right cuneus decreased. Correlation analysis showed that the ReHo values in right MFG positively correlated with attention/vigilance impairments, social cognition deficits, and the severity of clinical manifestations. CONCLUSIONS: These findings suggested that abnormal spontaneous activities in right MFG reflect illness severity and cognitive deficits, which also serve as a basis for establishing objective diagnostic markers and might be a clinical intervention target for treating patients with schizophrenia.

Association between increased BMI and cognitive function in first-episode drug-naïve male schizophrenia.

Objective: Although the adverse effects of obesity in schizophrenia are documented, there is limited research exists on the implications for untreated initial schizophrenia. Our investigation aimed to explore the connections between BMI and cognitive function in first-episode drug-naïve (FEDN)schizophrenia. Methods: We enrolled 143 FEDN schizophrenia patients, and collected data on their body mass index, fasting blood glucose and lipid levels. Cognitive function was measured with the MATRICS Consensus Cognitive Battery (MCCB). Using correlation and regression analysis to assess the relationship between BMI and cognitive performance. Results: The prevalence rate of overweight plus obesity in FEDN schizophrenia patients was 33.57%. Patients with FEDN schizophrenia exhibited extensive cognitive impairment, and those who were overweight/obesity demonstrated more severe impairments in working memory and visual learning when compared to normal/under weight counterparts. Correlation analysis indicated a negative association between working memory and BMI and TG, as well as a link between visual learning and BMI and LDL-C. Multiple linear regression analysis revealed that a higher BMI predicted a decrease in working memory in FEDN schizophrenia patients. Conclusion: Our results indicate that the rate of overweight plus obesity is high in FEDN schizophrenia patients, and there is an association between BMI and cognitive function in schizophrenia, particularly in relation to working memory.

Shared and distinct structural brain alterations and cognitive features in drug-naïve schizophrenia and bipolar disorder.

Our study aimed to examine the shared and distinct structural brain alterations, including cortical thickness(CT) and local gyrification index(LGI), and cognitive impairments between the early course stage of drug-naïve schizophrenia(SZ) and bipolar disorder(BD) patients when compared to healthy controls(HCs), and to further explore the correlation between altered brain structure and cognitive impairments. We included 72 SZ patients, 35 BD patients and 43 HCs. The cognitive function was assessed using the MATRICS Consensus Cognitive Battery. Cerebral cortex analyses were performed with FreeSurfer. Furthermore, any structural aberrations related to cognition impairments were examined. Cognitive impairments existed in SZ and BD patients and were much more severe and widespread in SZ patients, compared to HCs. There were no significant differences in LGI among three groups. Compared to HCs, SZ had thicker cortex in left pars triangularis, and BD showed thinner CT in left postcentral gyrus. In addition, BD showed thinner cortex in left pars triangularis, left pars opercularis, left insula and right fusiform gyrus compared to SZ. Moreover, our results indicated that CT in many brain areas were significantly correlated with cognitive function in HCs, but only CT of left pars triangularis was correlated with impaired social cognition found in SZ. The findings suggest that changes of CT in the left pars triangularis and left postcentral gyrus may be potential pathophysiological mechanisms of the cognition impairments in SZ and BD, respectively, and the divergent CT of partly brain areas in BD vs. SZ may help distinguish them in early phases.

Effects of 16 Weeks of Cheerleading on Physical Self-Esteem and Mental Health of Female College Students.

Objective: This study aimed to analyze the influence of cheerleading on female college students' physical self-esteem and mental health. Materials and Methods: In total, 63 female college students from the University of Electronic Science and Technology of China were trained in cheerleading for 16 weeks. The scores of each sub-field of physical self-esteem and psychological symptoms were analyzed by using Physical Self-Perception Profile (PSPP) and Symptom Checklist 90 (SCL-90), respectively, at 0 and 16 weeks of the experiment. Results: After 16 weeks of cheerleading exercise, female college students had significant differences in physical attractiveness (T = 4.18), physical quality (T = 4.39), and physical self-worth (T = 3.35) before and after the experiment (P < 0.01). There were significant differences in physical condition (T = 3.87) and athletic ability (T = 2.88) before and after the experiment (P < 0.05). Somatization (T = 6.485), obsessive-compulsive symptoms (T = 11.716), interpersonal sensitivity (T = 10.077), depression (T = 8.403), anxiety (T = 10.767), hostility (T = 10.866), terror (T = 9.260), paranoia (T = 10.414), psychosis (T = 9.610), sleep and eating disorders (T = 9.323), total symptom index (T = 13.245), and mean score of positive symptoms (T = 12.237) were significantly different (P < 0.01). Conclusion: Cheerleading can significantly improve the level of female college students' physical self-esteem, especially the self-esteem level of physical attractiveness, physical quality, and physical self-worth. They also experienced significant improvement in their psychological disorders, especially somatization, depression, and sleep and eating disorders, which effectively improved their overall mental health.

Association of Reduced Local Activities in the Default Mode and Sensorimotor Networks with Clinical Characteristics in First-diagnosed Episode of Schizophrenia.

The neurodevelopmental hypothesis states that schizophrenia is a brain disease. Exploring abnormal brain activities can improve understanding of the neural pathologic mechanism of clinical characteristics and determine subjective biomarkers to differentiate patients with schizophrenia from healthy controls. We collected clinical characteristics (i.e., demographics, positive and negative syndrome scale (PANSS) scores, and cognitive scores) and magnetic resonance imaging (MRI) data from 57 first-diagnosed drug-naïve patients with schizophrenia and 50 healthy controls. The fractional amplitude of low-frequency fluctuation (fALFF) was used to detect local activities. Partial correlation analysis was applied to estimate the relationship between abnormal regions and clinical characteristics. The support vector machine (SVM) analysis was used to calculate the accuracy of classification in abnormal regions. In our study, the fALFF values in the right postcentral gyrus, left precentral gyrus/postcentral gyrus, left postcentral gyrus/superior parietal lobule, bilateral supplementarymotor area, bilateral paracentral lobule, and bilateral precuneus were decreased in patients with schizophrenia and associated with clinical characteristics. However, the related patterns of cognition of patients were different from those of healthy controls. Additionally, the combination of fALFF values in the bilateral paracentral lobule and right postcentral gyrus might distinguish patients with schizophrenia from healthy controls with high accuracy (98.13%), specificity (98.00%), and sensitivity (98.25%). Our study suggests that reduced local activities in the default mode network and sensorimotor network may be regarded as neural underpinnings of clinical characteristics and may discriminate patients with schizophrenia from healthy controls.

Altered resting-state functional connectivity of the right precuneus and cognition between depressed and non-depressed schizophrenia.

The study investigated the resting-state functional connectivity (FC) and cognitive changes in patients with depressed schizophrenia(DS) and non-depressed schizophrenia(NDS). Eighty patients with first-episode schizophrenia and 50 healthy controls (HC) were included to conduct resting-state fMRI. All participants completed MATRICS Consensus Cognitive Battery (MCCB). The right precuneus was selected as the seed in whole-brain FC analysis. Our results showed the cognitive function (All MCCB dimensions) of all schizophrenia patients were worse than HC, but no differences were found between DS and NDS. The DS had decreased FC than NDS between the right precuneus and left middle cingulate gyrus, left cerebellum, right cerebellum. The DS had increased FC than HC between the right precuneus and temporal lobe, occipital lobe, and decreased FC between the right precuneus and left cerebellum. However, the NDS had increased FC than HC between the right precuneus and left cerebellum, right cerebellum, temporal lobe, occipital lobe, left superior parietal lobule. Correlation analysis showed that FC between the right precuneus and occipital lobe was negatively correlated with visual learning in DS and with social cognition in NDS. Our results suggest DS and NDS patients have different patterns of FC, and their FC changes correlate with different domains of cognition.

The Relationship Between Abnormal Resting-State Functional Connectivity of the Left Superior Frontal Gyrus and Cognitive Impairments in Youth-Onset Drug-Naïve Schizophrenia.

Objective: Age of onset is one of the heterogeneous factors in schizophrenia, and an earlier onset of the disease indicated a worse prognosis. The left superior frontal gyrus (SFG) is involved in numerous cognitive and motor control tasks. Hence, we explored the relationship between abnormal changes in SFG resting-state functional connectivity (rsFC) and cognitive function in the peak age of incidence to understand better the pathophysiological mechanism in youth-onset drug-naïve schizophrenia to search for reliable biomarkers. Methods: About 66 youth-onset drug-naïve schizophrenia patients and 59 healthy controls (HCs) were included in this study. Abnormal connectivity changes in the left SFG and whole brain were measured using the region of interest (ROI) rsFC analysis method. The cognitive function was assessed using the MATRICS Consensus Cognitive Battery (MCCB), and the severity of the clinical symptoms was evaluated by positive and negative syndrome scale (PANSS). Furthermore, we analyzed the relationships among abnormal FC values, cognition scores, and clinical symptoms. Results: We found decreased FC between left SFG and bilateral precuneus (PCUN), right hippocampus, right parahippocampal gyrus, left thalamus, left caudate, insula, and right superior parietal lobule (SPL), whereas increased FC was seen between the left SFG and right middle frontal gyrus (MFG) in the youth-onset drug-naïve schizophrenia group, compared with HCs. Meanwhile, the T-scores were lower in each cognitive domain than HCs. Moreover, in the youth-onset drug-naive schizophrenia group, the insula was negatively correlated with processing speed. No significant correlations were found between the FC-value and PANSS score. Conclusions: Our findings suggest widespread FC network abnormalities in the left SFG and widespread cognitive impairments in the early stages of schizophrenia. The dysfunctional connectivity of the left SFG may be a potential pathophysiological mechanism in youth-onset drug-naïve schizophrenia.

Abnormal regional homogeneity (ReHo) and fractional amplitude of low frequency fluctuations (fALFF) in first-episode drug-naïve schizophrenia patients comorbid with depression.

The current study aimed to characterize the regional homogeneity (ReHo) or fractional amplitude of low frequency fluctuations (fALFF) alterations in first-episode drug-naïve schizophrenia comorbid with depression. Sixty-nine first-episode drug-naïve schizophrenia patients and 34 healthy controls (HC) were included in the final analysis. Schizophrenia patients were divided into depressive patients (DP) and non-depressive patients (NDP), with 35 and 34 patients respectively, using the Hamilton Rating Scale for Depression -17(HRSD-17). All participants underwent resting-state fMRI (rs-fMRI), the fALFF (slow-4 and slow-5 bands) and ReHo were used to process the data. The results revealed eleven brain regions with altered slow-5 fALFF, eleven brain regions with altered slow-4 fALFF and ten brain regions with altered ReHo among DP, NDP and HC groups. Compared to NDP, the DP group had increased slow-5 fALFF in the Right Inferior Temporal Gyrus, increased ReHo in the Right Superior and Inferior Frontal Gyrus. The altered slow-5 fALFF in the Right Inferior Temporal Gyrus, altered ReHo in the Right Inferior Frontal Gyrus and Superior Frontal Gyrus were all positively correlated with the depressive symptoms in patients. However, there were no significant differences in slow-4 fALFF between DP and NDP groups. Our results indicate that the increased slow-5 fALFF in the Right Inferior Temporal Gyrus, increased ReHo in the Right Superior and Inferior Frontal Gyrus were associated with depressive symptoms in schizophrenia, which may provide preliminary evidence in better understanding the neural mechanisms underlying depressive symptoms in schizophrenia.

Reduced white matter integrity associated with cognitive deficits in patients with drug-naive first-episode schizophrenia revealed by diffusion tensor imaging.

Patients with schizophrenia have shown widespread white matter microstructural abnormalities and cognitive deficits, but the definitive relationship between white matter and cognitive performance remains unclear. In this study, we investigated the possible associations between white matter integrity and cognitive deficits in drug-naive first-episode schizophrenia (dn-FES) using diffusion tensor imaging (DTI). A total of 96 participants, including 46 dn-FES patients and 50 healthy individuals, underwent 3.0 T magnetic resonance diffusion-weighted imaging and cognitive assessments using the Chinese version of the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB). Group differences were tested using tract-based spatial statistics (TBSS). Compared with the control group, the dn-FES group exhibited reduced white matter integrity, as indexed using fractional anisotropy (FA) metrics, in the right-hemispheric cluster comprising the posterior thalamic radiation, posterior corona radiata, superior longitudinal fasciculus, retrolenticular part of the internal capsule, tapetum, splenium of the corpus callosum, sagittal stratum, and inferior longitudinal fasciculus. We found that social cognitive deficit is significantly correlated with reduced FA in these white matter regions, except the sagittal stratum and inferior longitudinal fasciculus. Furthermore, we found that speed of processing is positively correlated with reduced FA in the right superior longitudinal fasciculus of dn-FES patients. In summary, white matter deficits were validated in dn-FES patients and could be associated with speed of processing and social cognition, providing clues about a neural basis of schizophrenia and a potential biomarker for clinical studies.

Enhanced Prefrontal Regional Homogeneity and Its Correlations With Cognitive Dysfunction/Psychopathology in Patients With First-Diagnosed and Drug-Naive Schizophrenia.

Background: Schizophrenia, regarded as a neurodevelopmental disorder, is characterized by positive symptoms, negative symptoms, and cognitive dysfunction. Investigating the spontaneous brain activity in patients with schizophrenia can help us understand the underlying pathophysiologic mechanism of schizophrenia. However, results concerning abnormal neural activities and their correlations with cognitive dysfunction/psychopathology of patients with schizophrenia were inconsistent. Methods: We recruited 57 first-diagnosed and drug-naive patients with schizophrenia and 50 matched healthy controls underwent magnetic resonance imaging. The Positive and Negative Syndrome Scale (PANSS) and the MATRICS Consensus Cognitive Battery were used to assess the psychopathology/cognitive dysfunction. Regional homogeneity (ReHo) was used to explore neural activities. Correlation analyses were calculated between abnormal ReHo values and PANSS scores/standardized cognitive scores. Lastly, support vector machine analyses were conducted to evaluate the accuracy of abnormal ReHo values in distinguishing patients with schizophrenia from healthy controls. Results: Patients with schizophrenia showed cognitive dysfunction, and increased ReHo values in the right gyrus rectus, right inferior frontal gyrus/insula and left inferior frontal gyrus/insula compared with those of healthy controls. The ReHo values in the right inferior frontal gyrus/insula were positively correlated with negative symptom scores and negatively correlated with Hopkins verbal learning test-revised/verbal learning. Our results showed that the combination of increased ReHo values in the left inferior frontal gyrus/insula and right gyrus rectus had 78.5% (84/107) accuracy, 85.96% (49/57) sensitivity, and 70.00% specificity, which were higher than other combinations. Conclusions: Hyperactivities were primarily located in the prefrontal regions, and increased ReHo values in the right inferior frontal gyrus/insula might reflect the severity of negative symptoms and verbal learning abilities. The combined increases of ReHo values in these regions might be an underlying biomarker in differentiating patients with schizophrenia from healthy controls.

Quality of Life and Its Correlates in Alcohol Use Disorder Patients With and Without Depression in China.

Objective: Alcohol use disorder (AUD) is a serious issue worldwide and frequently co-occurs with depression. However, the quality of life (QOL) of AUD patients with and without depression is not well studied in the Chinese Han population. The aim of this study was to investigate QOL and its correlates in AUD patients with and without depression in China. Methods: Five hundred and fifteen psychiatric patients diagnosed with AUD were recruited. All these patients completed the Beck Depression Inventory (BDI) to assess depression, the Medical Outcome Study 36-Item Short Form Health Survey (SF-36) to evaluate QOL and the Alcohol Use Disorders Identification Test (AUDIT) to measure the severity of drinking. Results: Compared with AUD patients without depression, those with depression had a lower QOL in all eight domains of the SF-36 (all P < 0.001), but were more willing to have alcohol-related treatment (P < 0.05). Negative correlations were noted between (i) the BDI total score and all eight domains of the SF-36 (all P < 0.001); and (ii) between the AUDIT total score and six domains of the SF-36 (all P < 0.05). Conclusions: Depression impairs QOL in patients with AUD in China. Early intervention in comorbid depression to improve QOL is needed.

Prevalence, Demographic, and Clinical Correlates of Comorbid Depressive Symptoms in Chinese Psychiatric Patients With Alcohol Dependence.

BACKGROUND: Depressive symptoms are common among psychiatric patients with alcohol dependence (AD). However, the prevalence and clinical correlates of comorbid depressive symptoms are less well studied in Chinese Han patients. METHODS: In this hospital-based survey, we recruited 378 psychiatric patients diagnosed with AD according to the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV). All patients completed the Beck Depression Inventory (BDI) to evaluate depressive symptoms and the Alcohol Use Disorders Identification Test (AUDIT) to assess the severity of drinking. RESULTS: Compared to patients without depressive symptoms, 48.9% (185/378) of the patients with comorbid depressive symptoms were younger, had a more unstable marital status, had a higher AUDIT total score, and had a higher adverse consequences subscore (all P < 0.05). Further logistic regression analysis showed that unstable marital status (Odds ratios [OR] = 2.20, 95% confidence interval [CI] 1.21-3.99) and AUDIT total score (OR=1.07, 95% CI 1.03-1.11) were significantly associated with depressive symptoms. CONCLUSIONS: Our findings indicate high comorbidity between AD and depressive symptoms in Chinese psychiatric patients. Moreover, some variables are correlates of comorbid depressive symptoms. Particular attention should be paid to the early detection and intervention for this comorbid condition and its risk factors.

Distinguishing Between Treatment-Resistant and Non-Treatment-Resistant Schizophrenia Using Regional Homogeneity.

Background: Patients with treatment-resistant schizophrenia (TRS) and non-treatment-resistant schizophrenia (NTRS) respond to antipsychotic drugs differently. Previous studies demonstrated that patients with TRS or NTRS exhibited abnormal neural activity in different brain regions. Accordingly, in the present study, we tested the hypothesis that a regional homogeneity (ReHo) approach could be used to distinguish between patients with TRS and NTRS. Methods: A total of 17 patients with TRS, 17 patients with NTRS, and 29 healthy controls (HCs) matched in sex, age, and education levels were recruited to undergo resting-state functional magnetic resonance imaging (RS-fMRI). ReHo was used to process the data. ANCOVA followed by post-hoc t-tests, receiver operating characteristic curves (ROC), and correlation analyses were applied for the data analysis. Results: ANCOVA analysis revealed widespread differences in ReHo among the three groups in the occipital, frontal, temporal, and parietal lobes. ROC results indicated that the optimal sensitivity and specificity of the ReHo values in the left postcentral gyrus, left inferior frontal gyrus/triangular part, and right fusiform could differentiate TRS from NTRS, TRS from HCs, and NTRS from HCs were 94.12 and 82.35%, 100 and 86.21%, and 82.35 and 93.10%, respectively. No correlation was found between abnormal ReHo and clinical symptoms in patients with TRS or NTRS. Conclusions: TRS and NTRS shared most brain regions with abnormal neural activity. Abnormal ReHo values in certain brain regions might be applied to differentiate TRS from NTRS, TRS from HC, and NTRS from HC with high sensitivity and specificity.

Prevalence, correlates and treatment status of alcohol use disorders in psychiatric patients in China.

OBJECTIVE: To determine the prevalence, associated factors and treatment status of alcohol use disorders (AUDs) in psychiatric patients in China. METHODS: We asked 24,379 consecutive patients aged ≥18years who presented at the psychiatric departments in eight hospitals in 2013 whether they had consumed alcoholic beverages in the previous month. Of the 2964 (12.2%) patients who answered yes and were then screened with the Alcohol Use Disorders Identification Test (AUDIT), 1304 (5.3%) screened positive (AUDIT≥7) and, based on DSM-IV criteria, were diagnosed with AUDs by psychiatrists. The treatments prescribed for them were also recorded. Logistic regression was used to identify AUDs associated factors. RESULTS: The prevalence of AUDs was 2.4% (95% CI: 2.2-2.6%). None of the patients diagnosed with AUDs had got medical treatment for preventing relapse. The risk factors for AUDs were middle-aged or elderly (OR=1.86, 95% CI: 1.23-2.80), and consuming beverages with high degree of alcohol content (OR=2.92, 95% CI: 2.11-4.06). CONCLUSIONS: The prevalence of AUDs in psychiatric patients in China was not high, but the rate of treatment was dramatically low, indicating the serious neglect of AUDs. Our study suggests an urgent need to improve the situation of unmet need for treatment of psychiatric patients with AUDs.

The effectiveness and safety of amisulpride in Chinese patients with schizophrenia: An 8-week, prospective, open-label, multicenter, single-arm study.

INTRODUCTION: This study evaluated the effectiveness and safety of amisulpride in Chinese schizophrenia patients. METHODS: A multicenter, single-arm Phase IV study (NCT01795183). Chinese patients with schizophrenia received amisulpride for 8 weeks. The primary endpoint was ≥50% decrease in Positive and Negative Syndrome Scale total score from Baseline to Week 8. RESULTS: A total of 316 patients were enrolled; 295 were included in the effectiveness analysis; 66.8% (197/295) achieved ≥50% decrease in Positive and Negative Syndrome Scale total score from Baseline to Week 8. Nine patients discontinued treatment because of adverse events. DISCUSSION: Amisulpride had clinical effectiveness and was relatively well tolerated in Chinese patients with schizophrenia.

Hexanucleotide Repeat Expansion in C9ORF72 Is Not Detected in the Treatment-Resistant Schizophrenia Patients of Chinese Han.

Hexanucleotide (GGGGCC) repeat expansion in C9ORF72 (HRE) causes frontotemporal lobar degeneration, frontotemporal dementia-amyotrophic lateral sclerosis, and amyotrophic lateral sclerosis. HRE was also seen in the genomes of patients suffering from several other degenerative diseases. However, whether it is present in the treatment-resistant schizophrenia patients remains unknown. Genotyping 386 patients suffering from treatment-resistant schizophrenia using the method of Repeat-Primed PCR, we reported here that no HRE was detected in the patients of Chinese Han.