統合失調症におけるSalience Network機能障害、抑うつ気分、および主観的QOLの因果関係を評価する構造方程式モデリングアプローチ : 独立成分分析による安静時ｆMRI研究
Ohta, Masashi Tokushima University
Nakataki, Masahito Tokushima University Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Takeda, Tomoya Tokushima University
Numata, Shusuke Tokushima University Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Kinoshita, Makoto Tokushima University Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Matsuura, Kanae Tokushima University
Otomo, Maki Tokushima University
Takeichi, Naoya Tokushima University
Harada, Masafumi Tokushima University Tokushima University Educator and Researcher Directory KAKEN Search Researchers
structural equation modeling
subjective quality of life
Thesis or Dissertation
Purpose: Quality of life (QOL) is an important clinical outcome for patients with schizophrenia, and recent studies have focused on subjective QOL. We evaluated the causal relationship between psychosocial aspect of subjective QOL, symptoms, cognitive functions, and salience network (SN) dysfunction in schizophrenia using structural equation modeling (SEM).
Patients and methods: We performed a cross-sectional study of 21 patients with symptomatically stabilized schizophrenia and 21 age-, sex-, and education level-matched healthy controls who underwent resting-state functional magnetic resonance imaging. We evaluated SN dysfunction in schizophrenia using independent component analysis (ICA). We rated participant psychopathology using the Positive and Negative Syndrome Scale (PANSS), the Brief Assessment of Cognition in Schizophrenia (BACS), and the Calgary Depression Scale for Schizophrenia (CDSS). We rated psychosocial aspect of subjective QOL using the Schizophrenia Quality of Life Scale (SQLS) psychosocial subscale. We applied SEM to examine the relationships between SN dysfunction, PANSS positive and negative scores, CDSS total scores, BACS composite scores, and SQLS psychosocial subscale scores.
Results: In second-level analysis after group ICA, patient group had significant lower right pallidum functional connectivity (FC) within the SN than the controls did (Montreal Neurological Institute [MNI] [x y z] = [22 -2 -6]) (p = 0.027, family-wise error [FWE] corrected). In SEM, we obtained a good fit for an SEM model in which SN dysfunction causes depressed mood, which in turn determines psychosocial aspect of subjective QOL (chi-squared p = 0.9, root mean square error of approximation (RMSEA) < 0.001, comparative fit index [CFI] = 1.00, and standardized root mean square residual [SRMR]= 0.020).
Conclusion: We found a continuous process by which SN dysfunction causes depressed moods that determine psychosocial aspect of subjective QOL in schizophrenia. This is the first report that offers a unified explanation of functional neuroimaging, symptoms, and outcomes. Future studies combining neuroimaging techniques and clinical assessments would elucidate schizophrenia’s pathogenesis.
Neuropsychiatric Disease and Treatment
本論文は, 著者Masashi Ohtaの学位論文として提出され, 学位審査・授与の対象となっている。
© 2018 Ohta et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/ ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
|DOI (Published Version)|
|URL ( Publisher's Version )|
k3255_abstract_review.pdf 258 KB
k3255_fulltext.pdf 2.47 MB
|MEXT report number||
Doctor of Medical Science