Abstract
Schizotypal disorder lies in the schizophrenia spectrum and is widely studied in adult populations. Schizotypal disorder in children (SDc) is less well described. This study examined brain morphological and functional connectivity abnormalities in SDc (12 SDc and 9 typically developing children), focusing on the default mode and executive control brain networks. Results indicated that SDc is associated with reduced grey matter volume (GMV) in superior and medial frontal gyri, and increased resting-state functional connectivity between the superior frontal gyrus and inferior parietal lobule, compared to typically developing children (cluster-level FWE-corrected p < 0.05). The brain structure abnormality (GMV in left superior frontal gyrus) was correlated with clinical symptoms in SDc (r = −0.66, p = 0.026) and functional connectivity abnormality was correlated with extra-dimensional shifting impairments in all participants (r = 0.62, p = 0.011), suggesting their contribution to the underlying mechanisms of clinical presentation. These preliminary results motivate further work to characterize the neural basis of SDc and its significance as a risk factor for later psychosis.
Highlights
Schizotypal disorder (SD) lies within the schizophrenia spectrum and represents one of the high-risk groups for schizophrenia.[1,2,3]There is a growing interest in childhood manifestations of schizotypal disorder (SDc),[4,5] which are characterized by bizarre magical and paranoid fantasies and perceptual disturbances preoccupying the internal world of the child.[2,3,4] These preoccupying thoughts interfere with normal social interaction and activities, and cause anxiety and distress.[5]
We examined the neural impairments in Schizotypal disorder in children (SDc)
We identified brain structural and functional abnormalities of SDc and suggest these abnormalities may be related to the cognitive and clinical symptoms of SDc
Summary
Schizotypal disorder (SD) lies within the schizophrenia spectrum and represents one of the high-risk groups for schizophrenia.[1,2,3]There is a growing interest in childhood manifestations of schizotypal disorder (SDc),[4,5] which are characterized by bizarre magical and paranoid fantasies and perceptual disturbances preoccupying the internal world of the child.[2,3,4] These preoccupying thoughts interfere with normal social interaction and activities, and cause anxiety and distress.[5]. Studies in healthy participants have consistently shown that when an individual is engaged in internally-oriented processes, the default mode network (DMN, including medial prefrontal cortex, posterior cingulate cortex, medial temporal lobe, and angular gyrus) is activated and the executive control network (ECN, including dorsal lateral prefrontal cortex, and superior parietal lobules) is deactivated;[10,11] the opposite pattern is evident during externally-oriented and goal-directed tasks.[12] The DMN and ECN are affected in schizophrenia patients and adults with SD, both structurally and functionally.[13,14] Adults with SD are consistently reported to have reduced grey matter volume (GMV) in the medial temporal lobe, with more variable evidence of prefrontal cortical involvement.[15] Functionally, abnormalities within the DMN have been reported in individuals with SD, including both increased and decreased resting-state functional connectivity compared to controls.[16] During cognitive tasks, individuals with SD showed different profiles of activation within the ECN compared to controls.[17,18,19] No study has yet been conducted to examine the neural basis of SDc. This study hypothesized that brain structural (GMV) abnormalities would manifest in SDc, relative to typically developing children, within the DMN and ECN, and that these structural changes would be associated with largescale functional (resting-state connectivity) impairments
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