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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
著者
大田, 将史 徳島大学大学院医科学教育部(医学専攻) 徳島大学 教育研究者総覧
武田, 知也 Tokushima University
Matsuura, Kanae Tokushima University
Otomo, Maki Tokushima University
Takeichi, Naoya Tokushima University
キーワード
depressed mood
salience network
schizophrenia
structural equation modeling
subjective quality of life
resting-state fMRI
資料タイプ
学位論文
抄録
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.
掲載誌名
Neuropsychiatric Disease and Treatment
ISSN
11782021
出版者
Dovepress
14
開始ページ
1585
終了ページ
1597
発行日
2018-06-15
備考
内容要旨・審査要旨・論文本文の公開
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。
権利情報
© 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).
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出版社版DOI
出版社版URL
フルテキストファイル
言語
eng
著者版フラグ
博士論文全文を含む
文科省報告番号
甲第3255号
学位記番号
甲医第1404号
学位授与年月日
2019-03-22
学位名
博士(医学)
学位授与機関
徳島大学
部局
病院
医学系