Abstract
Introduction: Cognitive decline is the core schizophrenia symptom, which is now well accepted. Holding a role in various aspects of cognition, lentiform nucleus (putamen and globus pallidus) dysfunction contributes to the psychopathology of this disease. However, the effects of lentiform nucleus function on cognitive impairments in schizophrenia are yet to be investigated.Objectives: We aim to detect the fractional amplitude of low-frequency fluctuation (fALFF) alterations in patients with schizophrenia, and examine how their behavior correlates in relation to the cognitive impairments of the patients.Methods: All participants underwent magnetic resonance imaging (MRI) and cognitive assessment (digit span and digit symbol coding tests). Screening of brain regions with significant changes in fALFF values was based on analysis of the whole brain. The data were analyzed between Jun 2020 and Mar 2021. There were no interventions beyond the routine therapy determined by their clinicians on the basis of standard clinical practice.Results: There were 136 patients (75 men and 61 women, 24.1 ± 7.4 years old) and 146 healthy controls (82 men and 64 women, 24.2 ± 5.2 years old) involved in the experiments seriatim. Patients with schizophrenia exhibited decreased raw scores in cognitive tests (p < 0.001) and increased fALFF in the bilateral lentiform nuclei (left: 67 voxels; x = −24, y = −6, z = 3; peak t-value = 6.90; right: 16 voxels; x = 18, y = 0, z = 3; peak t-value = 6.36). The fALFF values in the bilateral lentiform nuclei were positively correlated with digit span-backward test scores (left: r = 0.193, p = 0.027; right: r = 0.190, p = 0.030), and the right lentiform nucleus was positively correlated with digit symbol coding scores (r = 0.209, p = 0.016).Conclusion: This study demonstrates that cognitive impairments in schizophrenia are associated with lentiform nucleus function as revealed by MRI, involving working memory and processing speed.
Highlights
Cognitive decline is the core schizophrenia symptom, which is well accepted
We aim to detect the fractional amplitude of low-frequency fluctuation alterations in patients with schizophrenia, and examine how their behavior correlates in relation to the cognitive impairments of the patients
The fractional amplitude of low-frequency fluctuation (fALFF) values in the bilateral lentiform nuclei were positively correlated with digit span-backward test scores, and the right lentiform nucleus was positively correlated with digit symbol coding scores (r = 0.209, p = 0.016)
Summary
Cognitive decline is the core schizophrenia symptom, which is well accepted. Holding a role in various aspects of cognition, lentiform nucleus (putamen and globus pallidus) dysfunction contributes to the psychopathology of this disease. Cognitive function is impaired across almost all domains (Kern et al, 2011; Georgiades et al, 2017; Zhang et al, 2019) and contributes substantially to the long-term outcome associated with schizophrenia (Lepage et al, 2014; Mucci et al, 2021), highlighting cognitive symptoms as important targets for treatment. Previous studies have demonstrated that patients with firstepisode schizophrenia showed cognitive deficits across all cognitive domains, in processing speed (Kern et al, 2011; Georgiades et al, 2017; Zhang et al, 2019). The underlying brain structural and functional mechanisms for the cognitive symptoms remain to be identified (McCutcheon et al, 2020)
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