经颅磁刺激改善首发精神分裂症患者认知功能的影像遗传学机制研究

Only partially patients have effects when using repetitive transcranial magnetic stimulation (rTMS) to treat cognitive dysfunction in schizophrenia. It is worthy to investigate the imaging genetics mechanism of effective treatment. Based on the key roles of theory of mind (ToM) and glutamate neurotransmitter in the realization of cognitive function, we intend to choose the first-episode negative schizophrenia patients with cognitive dysfunction as the main symptoms. The first step is to obtain the brain structural and ToM tasking-state functional magnetic resonance imagings and detect gene loci information of glutamate receptors related to the etiology of schizophrenia. Then, we use MATRICS consensus cognitive battery (MCCB) and personal and social performance scales to evaluate the improvement degree of cognitive function after rTMS treatment. In the third step, combing the features of gene polymorphism and clinical behaviors, We utilize brain connectomics methods to investigate the imaging genetics mechanism for improving cognitive function in the first-episode schizophrenia patients by rTMS and explore the genic, brain structural and functional characteristics which could predict the curative effects of rTMS. This project is not only to provide a theoretical basis of the clinical individualized treatment but also to offer guidance for the selection of patients with schizophrenia who are suitable for applying rTMS.

重复经颅磁刺激在改善精神分裂症患者认知功能障碍的临床治疗中，仅部分患者有效，该治疗有效的影像遗传学机制是值得研究的科学问题，将有助于探寻预测疗效的基因和脑影像特征。综合心理理论和谷氨酸神经传递在认知功能实现上的关键作用，本项目拟选择以认知功能障碍为主要症状的首发阴性精神分裂症患者为研究对象，获取患者治疗前后的脑结构和心理理论任务态功能磁共振影像；测查与心理理论和精神分裂症病因学相关的谷氨酸受体基因位点信息；采用精神分裂症认知功能成套测验和个人社会表现测评量表评估治疗后患者认知功能改善程度。结合基因多态性和临床行为学特征，运用脑连接组学方法，研究重复经颅磁刺激治疗首发阴性精神分裂症患者认知功能改善程度不同的影像遗传学机制，探寻预测重复经颅磁刺激疗效的基因、脑结构和功能特征。本项目的开展可为临床应用重复经颅磁刺激个性化治疗提供理论依据，亦为甄选适合重复经颅磁刺激治疗的精神分裂症患者提供指导。

重复经颅磁刺激在改善精神分裂症患者认知功能障碍的临床治疗中，仅部分患者有效，该治疗有效的影像遗传学机制是值得研究的科学问题，将有助于探寻预测疗效的基因和脑影像特征。综合心理理论和谷氨酸神经传递在认知功能实现上的关键作用，本项目拟选择以认知功能障碍为主要症状的首发阴性精神分裂症患者为研究对象，获取患者治疗前后的脑结构和心理理论任务态功能磁共振影像；测查与心理理论和精神分裂症病因学相关的谷氨酸受体基因位点信息；采用精神分裂症认知功能成套测验和个人社会表现测评量表评估治疗后患者认知功能改善程度。结合基因多态性和临床行为学特征，运用脑连接组学方法，研究重复经颅磁刺激治疗首发阴性精神分裂症患者认知功能改善程度不同的影像遗传学机制，探寻预测重复经颅磁刺激疗效的基因、脑结构和功能特征。本项目的开展可为临床应用重复经颅磁刺激个性化治疗提供理论依据，亦为甄选适合重复经颅磁刺激治疗的精神分裂症患者提供指导。