其他摘要 | Sensory gating can filter irrelevant sensory information. It can suppress irrelevant stimuli before the information is transferred to higher-order areas for fine processing, thereby protecting the integrity of cognition. This is a well-adapted inhibitory function of the brain. Sensory gating defects represented by P50 inhibition defects are repeatedly found in schizophrenia, which may be related to the core symptoms of schizophrenia, which is clinical manifestations and cognitive
impairment. However, the relationship between sensory gating and its neural mechanisms, clinical manifestations and cognitive impairment is still unclear. This study explored the sensory gating defects in patients with first-episode drug naïve schizophrenia through a three-part study to study the relationship between the representation of important brain areas related to sensory gating and clinical symptoms and cognitive impairment. Finally, the machine learning technology was used to predict the natural treatment efficacy and cognitive performance of patients with first-episode drug naive schizophrenia.
First, based on the study of sensory gating defects in schizophrenia, this thesis explored its relationship with clinical symptoms and cognitive performance. The first part of the study recruited 111 first-episode drug naive schizophrenia patients and 172 healthy controls to participate in the study. The Positive and Negative Symptom Scale (PANSS) was used to assess the patients' psychopathological symptoms, and the Measurement and Treatment Research to Improve Cognition Schizophrenia Consensus Cognitive Battery (MCCB) and Electroencephalogram (EEG) system were dministered to assess the cognitive performance and P50 inhibition of the subjects. The results showed that the first-episode untreated schizophrenia patients have sensory gating defects represented by P50 inhibition defects, which are characterized by a long S 1 latency and general cognitive impairment. There were correlations between S2 amplitude and PANSS total score, S2 latency and cognitive factors, indicating that the P50 components may be related to the psychopathological manifestations of schizophrenia. S 1 and S2 incubation periods are correlated with BVMT-R scores, S1 amplitude and spatial span scores, indicating that the P50
components may be the biomarkers of cognitive impairment in first-episode drug naive schizophrenia patients.
Second, this paper confirmed the brain representations related to sensory gating and explored its relationship with clinical symptoms and cognitive performance. The second part of the study recruited 48 first-episode drug naive schizophrenia patients participate in the study. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was used to assess the cognitive performance of patients with schizophrenia. The patient's psychopathological symptoms, cognitive performance, P50 inhibition were assessed. Magnetic resonance imaging (MRI) was used to record the patient's resting state function and structural image data. The results showed that the first-episode drug naive schizophrenia patients had correlations between gray matter volume (GMV) and functional connectivity (FC) and P50 components. There was a correlation between FC in these brain areas related to sensory gating and clinical symptoms and cognitive performance.
Finally, the indicators related to sensory gating obtained in the first and second parts were used as features to explore whether they could be used to predict the future curative effect, clinical symptoms and cognitive performance of patients with schizophrenia. The third part of the study recruited the same subjects in the second part and collected data on their psychopathological symptoms, cognitive performance, and resting state functopm and structure after 3 months of natural treatment. The results showed that the total score of PANSS and its subscales, the total scores of RBANS and its subscale, including immediate memory, visuospatial/ constructional, delayed memory, of first-episode drug naive schizophrenia patients improved after 3 months
of natural treatment. This improvement was also reflected in the structure and function of the brain, namely GMV and FC. At the same time, using the technology of machine learning, characterized by the FCz related to sensory gating obtained in the second study, realized the prediction of the response, efficacy and cognitive performance of the first-episode drug naive schizophrenic patients to natural therapy at the individual level. All the feature combinations including FCz showed the better results in prediction than single EEG data as feature.
Overall, this study filled some gaps in sensory gating research in the first-episode drug naive schizophrenia population. Studies found that sensory gating defects exist in the early stages of first-episode drug naive schizophrenia. And there was a correlation between this defect and clinical symptoms as well as cognitive performance. The FC between these areas related to sensory gating was a biomarker for the clinical symptoms of first-episode drug naive schizophrenia patients. It could successfully predict the treatment response, efficacy and cognitive performance of first-episode drug naive schizophrenia patients. |
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