4.3 Article

Altered thalamic subregion functional networks in patients with treatment-resistant schizophrenia

Journal

WORLD JOURNAL OF PSYCHIATRY
Volume 12, Issue 5, Pages 693-707

Publisher

BAISHIDENG PUBLISHING GROUP INC
DOI: 10.5498/wjp.v12.i5.693

Keywords

Treatment-resistant schizophrenia; Thalamus; Rs-fMRI; Functional connectivity; Thalamocortical pathway

Categories

Funding

  1. Korean Mental Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea [HL19C0015]
  2. Korea Health Industry Development Institute - Ministry of Health & Welfare, Republic of Korea [HR18C0016]

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This study aimed to investigate the functional network of thalamic subregions in patients with treatment-resistant schizophrenia (TRS). The findings revealed differences in functional connectivity within thalamic subregions and cortical networks between TRS patients and healthy controls. Increased connectivity between thalamic subregions and the sensorimotor cortex, frontal medial cortex, and lingual gyrus was also observed, which may be associated with the pathophysiology of TRS.
BACKGROUND The thalamus plays a key role in filtering information and has extensive interconnectivity with other brain regions. A large body of evidence points to impaired functional connectivity (FC) of the thalamocortical pathway in schizophrenia. However, the functional network of the thalamic subregions has not been investigated in patients with treatment-resistant schizophrenia (TRS). AIM To identify the neural mechanisms underlying TRS, we investigatedFC of thalamic sub-regions with cortical networks and voxels, and the associations of this FC with clinical symptoms. We hypothesized that the FC of thalamic sub-regions with cortical networks and voxels would differ between TRS patients and HCs. METHODS In total, 50 patients with TRS and 61 healthy controls (HCs) matched for age, sex, and education underwent resting-state functional magnetic resonance imaging (rs-fMRI) and clinical evaluation. Based on the rs-fMRI data, we conducted a FC analysis between thalamic subregions and cortical functional networks and voxels, and within thalamic subregions and cortical functional networks, in the patients with TRS. A functional parcellation atlas was used to segment the thalamus into nine subregions. Correlations between altered FC and TRS symptoms were explored. RESULTS We found differences in FC within thalamic subregions and cortical functional networks between patients with TRS and HCs. In addition, increased FC was observed between thalamic subregions and the sensorimotor cortex, frontal medial cortex, and lingual gyrus. These abnormalities were associated with the pathophysiology of TRS. CONCLUSION Our findings suggest that disrupted FC within thalamic subregions and cortical functional networks, and within the thalamocortical pathway, has potential as a marker for TRS. Our findings also improve our understanding of the relationship between the thalamocortical pathway and TRS symptoms. (c) The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.

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