Altered functional connectivity of insula in schizophrenia using functional magnetic resonance imaging / 中华行为医学与脑科学杂志

ABSTRACT

Objective To investigate the insula and its related network of schizophrenia patients and its correlation to behavior performance with functional magnetic resonance imaging.Methods Fourteen patients with paranoid schizophrenia and sixteen normal subjects received blood oxygenation level dependent functional magnetic resonance imaging(BOLD-fMRI) examinations based on resting state and digital 2-back working memory task.The fMRI data were processed and analyzed with SPM2,AFNI and Matlab software packages (thresholded at P =0.005,uncorrected).Medial prefrontal cortex (MPFC,BA10) was placed as region of interest (ROI).Results The functional connectivity positively or negatively correlated with MPFC was lower for patient group than that for control group in resting and task states.In resting state,the brain areas negatively correlated with MPFC mainly included the bilateral superior temporal gyrus (BA22),cuneus (BA 18/19),inferior parietal lobule (BA40),right parahippocampus for patient group and the bilateral insula/superior temporal gyrus(BA22),inferior parietal lobule(BA40),paracentral lobule,parahippocampus for control group.The brain areas positively correlated with MPFC mainly included the pineal gland areas for patient group and the left anterior nucleus thalamus,bilateral medial superior frontal gyrus (BA6),right inferior corpus callosum (BA34) and the cerebellar vermis for control group in resting state.In 2-back task,the brain areas negatively correlated with MPFC mainly included the right cerebellar hemisphere,left superior parietal lobule/precuneus (BA7),left superior frontal gyrus (BA6) for patient group and the left medial dorsal thalamus,bilateral lateral premotor area (BA6),left inferior parietal lobule/precuneus (BA7),right cerebellar hemisphere for control group.The accuracy of reaction was lower in patient group than that in control group((78.30 ± 8.76) ％ vs (89.89 ± 8.05) ％,P =0.01) and the correlation between the accuracy and the left medial dorsal thalamus had statistical significance (r =-0.52,P =0.04).Conclusion The altered functional connectivitv of the bilateral insula and its related network indicates functional disintegration of the limbic system in patients with schizophrenia.Widespreadly reduced functional connectivity and the functional disconnection of left medial dorsal thalamus mav be one of the reasons for poor behavior performance in schizophrenia patients.