Adverse Psychological Reactions and Psychological Aids for Medical Staff During the COVID-19 Outbreak in China.

Background: The outbreak of the novel coronavirus disease COVID-19 caused panic and psychological stress throughout the World. We investigated the extent of adverse psychological reactions in two medical staff groups in China, and explored the importance of online psychological assistance for them. Methods: A cross-sectional online survey including Hospital Anxiety and Depression Scale (HADS) and Insomnia Severity Index (ISI) was utilized to assess anxiety, depression, and insomnia. Propensity score matching (PSM) was applied to match sex and age between the two groups. Differences in the prevalence of adverse psychological reactions between the two groups were compared by a Chi-square test. A multivariate logistic regression analysis was utilized to search for associated adverse psychological reaction factors of two groups. Results: A total of 2,920 medical staff took part in the survey, including 470 frontline and 2,450 non-frontline medical staff. The risk of the frontline group experiencing anxiety, depression, insomnia-early, insomnia-middle, and insomnia-late were 1.16, 1.28, 1.26, 1.22, 1.28 times those of the non-frontline group after PSM. For frontline medical staff, the spinsterhood state (OR = 1.23, 95% CI: 1.00-1.51; P = 0.05) was a risk factor for anxiety. Bachelor or college degree (OR = 2.23, 95% CI: 1.24-4.02, P = 0.01) and a contact history with COVID-19 patients (OR = 1.62, 95% CI: 1.10-2.40; P = 0.02) were risk factors for insomnia. For non-frontline medical staff, being a woman (OR = 1.49, 95% CI: 1.08-2.06, P = 0.01) was a risk factor for anxiety, whilst being in a middle age group was a protective factor for anxiety (OR = 0.70, 95% CI: 0.50-0.99, P = 0.04) and depression (OR = 0.65, 95% CI: 0.45-0.93, P = 0.02). Being a woman (OR = 1.47, 95% CI: 1.14-1.89, P = 0.003) and working in a COVID-19 unit (OR = 1.31, 95% CI: 1.11-1.54, P = 0.001) were risk factors for insomnia, whilst the spinsterhood state (OR = 0.80, 95% CI: 0.67-0.95; P = 0.01) was a protective factor for insomnia. Online forms of psychological aid were all popular with medical staff. Conclusions: The prevalence of anxiety, depression, and insomnia in frontline medical staff was significantly higher than in the non-frontline group. Appropriate intervention methods should be adopted according to the different influencing factors of the two groups. Online psychological aid was the preferred mechanism for relieving psychological problems.

Frequency-specific alterations of the frontal-cerebellar circuit in first-episode, drug-naive somatization disorder.

BACKGROUND: With the development of imaging techniques, evidence of abnormal neural activity has been implicated in patients with somatization disorder (SD). It remains unclear whether abnormal spontaneous neural activities are related to specific frequency bands. In this study, resting-state functional magnetic resonance imaging (fMRI) using the frequency-specific amplitude of low frequency fluctuation (ALFF) approach was applied to investigate changes in spontaneous neural activity in different frequency bands in patients with SD. METHODS: Twenty-five first-episode, medication-naive patients with SD and 28 age-, sex-, education-matched healthy controls (HCs) underwent resting-state fMRI. The ALFF method with the classical low-frequency (0.01 - 0.08 Hz), slow-5 (0.01 - 0.027 Hz) and slow-4 (0.027 - 0.08 Hz) bands was employed to analyze the data. RESULTS: With the classical low-frequency and slow-5 bands, patients with SD showed significantly increased ALFF in the left orbitofrontal cortex (OFC) and reduced ALFF in the right cerebellum compared with HCs. With the slow-4 band, patients with SD exhibited significantly reduced ALFF in the right cerebellum compared with HCs. However, no significant correlation was observed between the ALFF value in the left OFC or right cerebellum and clinical/cognitive variables. CONCLUSIONS: Our findings indicate that there are abnormal regional activities of the left OFC and right cerebellum in first-episode, treatment-naive patients with SD, suggesting that these alterations occur early in the course of the disease and are independent of medication status. Our study provides novel evidence that different regional activities of the frontal-cerebellar circuit may be involved in the pathophysiology of SD.

Less reduced gray matter volume in the subregions of superior temporal gyrus predicts better treatment efficacy in drug-naive, first-episode schizophrenia.

Decreased gray matter volume (GMV) in the superior temporal gyrus (STG) has been implicated in the neurophysiology of schizophrenia. However, it remains unclear whether volumetric reduction in the subregions of the STG can predict treatment efficacy for schizophrenia. Our cohort included 44 drug-naive, first-episode patients, 42 unaffected siblings and 44 healthy controls. Voxel-based morphometry and pattern classification were utilized to analyze the acquired imaging data as per the anatomical subdivision by a well-defined brainnetome atlas. The patients presented lower GMV values in left TE1.0/1.2 (TE, anterior temporal visual association area) than the siblings, and lower GMV values in the left/right TE1.0/1.2 and left A22r (rostral area 22) than the controls. A positive correlation is observed between the GMV values in the right A38l (lateral area 38) and baseline Positive and Negative Syndrome Scale (PANSS) total scores in the patients. Support vector regression (SVR) results exhibited a significant association between predicted (based on the GMV values in the right A38l) and actual symptomatic improvement based on the reduction ratio of the PANSS total scores (r = 0.498, p = 0.001). Our results suggest that normal structure in the right A38l of the STG may be an important factor indicative of the effects of antipsychotic drugs, which can be potentially used to monitor drug effects for first-episode patients at an early stage in clinical practice.

Enhanced Connectivity of Thalamo-Cortical Networks in First-Episode, Treatment-Naive Somatization Disorder.

BACKGROUND: Dysfunctions of the thalamus and its projections to cortical cortices have been implicated in patient with somatization disorder (SD). However, changes in the anatomical specificity of thalamo-cortical functional connectivity (FC) in SD remain unclear. METHODS: Resting-state fMRI scans were collected in 25 first-episode, drug-naive patients with SD, as well as 28 sex-, age-, and education-matched healthy controls. We parcellated the thalamus with seven predefined regions of interest (ROIs) and used them as seeds to map whole-brain FC. Correlation analysis was conducted in the patients. RESULTS: We found an increased pattern of thalamic ROI-cortex connectivity in patients with SD. Patients with SD demonstrated enhanced thalamic connectivity to the bilateral anterior/middle cingulum, motor/sensory cortex, visual cortex, and auditory cortex. A significantly negative correlation was found between the right occipital thalamic ROI to the anterior cingulum and EPQ extraversion scores (r=0.404, p=0.045) after the Benjamini-Hochberg correction. CONCLUSIONS: This study demonstrates that anatomical specificity of enhanced thalamo-cortical FCs exists in first-episode, drug-naive patients with SD. These findings further highlight the importance of the thalamic subregions in the pathophysiology of SD.

Abnormal Functional Asymmetry in the Salience and Auditory Networks in First-episode, Drug-naive Somatization Disorder.

Evidence of abnormal functional connectivity (FC) has been implicated in patients with somatization disorder (SD). Although the importance of damage to the functional asymmetry has been established, it remains unclear as to whether abnormal intra- and inter-hemispheric FCs are related to patients with SD. We applied resting-state functional magnetic resonance imaging to first-episode, medication-naive patients with SD (n = 25) and matched healthy controls (HCs) (n = 28). The data were analyzed using parameter of asymmetry (PAS) and support vector machine (SVM). Patients with SD showed significantly lower PAS values in the left inferior temporal gyrus (ITG) and higher PAS values in the right insula compared to HCs. A negative correlation was observed between the higher PAS values in the right insula and the Hamilton Depression Scale (HAMD) sleep subscale scores (r = -0.502, p = 0.011), and positive correlations were found between the lower PAS values in the left ITG and the Hamilton Anxiety Scale (HAMA) somatic anxiety subscale scores (r = 0.443, p = 0.027) and the HAMA total scores (r = 0.456, p = 0.022). Moreover, the increased PAS values in the right insula could distinguish patients with SD from HCs with acceptable accuracy (77.36%). First-episode, treatment-naive patients with SD show disrupted asymmetry of inter- and intra-hemispheric FCs. The pattern of disrupted functional asymmetry occurs early in the course of the disease and is independent of medication status, which suggests that disrupted functional asymmetry of salience and auditory networks may be applied as early biological markers for SD.

Region-specific insular volumetric decreases in drug-naive, first-episode schizophrenia and their unaffected siblings.

Decreased insular volume may be one of the anatomical alterations caused by schizophrenia. The possibility of region-specific insular volumetric reduction as an endophenotype and/or a possible treatment predictor is a critical issue with great implications for the diagnosis and prognosis of the disease. The sample of the current study comprised 44 drug-naive and first-episode patients, 42 unaffected siblings, and 44 healthy controls. A computational anatomy toolbox (CAT12) was applied to analyze the structural images with a fine-grained, cross-validated brainnetome atlas. Correlation analysis and support vector regression (SVR) were used to determine the relationship between insular deficits and symptomatic severity among patients. The gray matter volume (GMV) values in the left hypergranular insula (G) exhibited the following pattern: patients < siblings < controls. GMV values in the right ventral agranular insula (vIa) and baseline Positive and Negative Syndrome Scale negative symptoms subscale scores among patients showed a positive correlation (r = 0.384, p = .010). Further SVR analysis exhibited a significantly positive correlation between GMV values in the right vIa and negative symptomatic improvement among patients (r = 0.537, p < .001). Results suggested the presence of region-specific insular volumetric decreases in first-episode schizophrenia. Thus, volumetric decrease in left G might be a potential endophenotype for schizophrenia, and GMV values in right vIa might be used to predict negative symptomatic improvement in schizophrenia.

Increased Nucleus Accumbens Connectivity in Resting-State Patients With Drug-Naive, First-Episode Somatization Disorder.

The nucleus accumbens (NAc) plays an important role in the reward circuit, and abnormal regional activities of the reward circuit have been reported in various psychiatric disorders including somatization disorder (SD). However, few researches are designed to analyze the NAc connectivity in SD. This study was designed to explore the NAc connectivity in first-episode, drug-naive patients with SD using the bilateral NAc as seeds. Twenty-five first-episode, drug-naive patients with SD and 28 healthy controls were recruited. Functional connectivity (FC) was designed to analyze the images. LIBSVM (a library for support vector machines) was used to identify whether abnormal FC could be utilized to discriminate the patients from the controls. The patients showed significantly increased FC between the left NAc and the right gyrus rectus and left medial prefrontal cortex/anterior cingulate cortex (MPFC/ACC), and between the right NAc and the left gyrus rectus and left MPFC/ACC compared with the controls. The patients could be separated from the controls through increased FC between the left NAc and the right gyrus rectus with a sensitivity of 88.00% and a specificity of 82.14%. The findings reveal that patients with SD have increased NAc connectivity with the frontal regions of the reward circuit. Increased left NAc-right gyrus rectus connectivity can be used as a potential marker to discriminate patients with SD from healthy controls. The study thus highlights the importance of the reward circuit in the neuropathology of SD.

Enhanced baseline activity in the left ventromedial putamen predicts individual treatment response in drug-naive, first-episode schizophrenia: Results from two independent study samples.

BACKGROUND: Antipsychotic medications are the common treatment for schizophrenia. However, reliable biomarkers that can predict individual treatment response are still lacking. The present study aimed to examine whether baseline putamen activity can predict individual treatment response in schizophrenia. METHODS: Two independent samples of patients with drug-naive, first-episode schizophrenia (32 patients in sample 1 and 44 in sample 2) and matched healthy controls underwent resting-state functional magnetic resonance imaging (fMRI) at baseline. Patients were treated with olanzapine for 8 weeks; symptom severity was assessed using the Positive and Negative Syndrome Scale (PANSS) at baseline and week 8. Fractional amplitude of low frequency fluctuation (fALFF) and pattern classification techniques were used to analyze the data. FINDINGS: Univariate analysis shows an elevated pre-treatment fALFF in the left ventromedial putamen in both patient samples compared to healthy controls (p's < 0.001). The support vector regression (SVR) analysis suggests a positive relationship between baseline pre-treatment fALFF in the left ventromedial putamen and improvement in positive symptom at week 8 in each patient group using a cross-validated method (r = 0.452, p = .002; r = 0.511, p = .003, respectively). INTERPRETATION: Our study suggests that elevated pre-treatment mean fALFF in the left ventromedial putamen may predict individual therapeutic response to olanzapine treatment in drug-naive, first-episode patients with schizophrenia. Future studies are needed to confirm whether this finding is generalizable to patients with schizophrenia treated with other antipsychotic medications. FUND: The National Key R&D Program of China and the National Natural Science Foundation of China.

Voxel-based global-brain functional connectivity alterations in first-episode drug-naive patients with somatization disorder.

BACKGROUND: Altered functional connectivity (FC) is associated with the pathophysiology of patients with somatization disorder (SD). However, inconsistent results were obtained due to different selections of regions of interest (ROIs) in previous researches. This study aims to examine voxel-wise brain-wide FC alterations in patients with first-episode, drug-naive SD in an unbiased way. METHODS: A total of 25 patients with SD and 28 age-, sex-, and education-matched healthy controls underwent resting-state functional magnetic resonance imaging. Global-brain FC (GFC) was applied to analyze the images. Receiver operating characteristic curves and support vector machine were used to differentiate the patients from the controls. RESULTS: Compared with healthy controls, patients with SD exhibited increased GFC in the right inferior temporal gyrus (t-value = 4.0663, p < 0.001) and left superior occipital gyrus (t-value = 3.8197, p < 0.001). Decreased GFC in the right insula (t-value = ‒4.1667, p < 0.001) was observed in the patients relative to the controls. The GFC values in the right insula of the patients were positively correlated to their scores of the sleep subscale of the Hamilton Depression Scale (r = 0.455, p = 0.022) and the lie subscale of the Eysenck Personality Questionnaire (r = 0.436, p = 0.029). A combination of GFC values in the right insula and left superior occipital gyrus can be applied to discriminate the patients from the controls with optimal sensitivity, specificity, and accuracy of 88.00%, 85.71%, and 86.79%, respectively. CONCLUSIONS: Our study indicates that patients with SD show abnormal GFC in the brain areas of insula-centered sensorimotor network, and thus providing a new perspective for understanding the pathological changes of FC in SD. Furthermore, a combination of the GFC values in the right insula and left superior occipital gyrus may be used as a potential biomarker to identify the patients from the controls.

Enhanced Global-Brain Functional Connectivity in the Left Superior Frontal Gyrus as a Possible Endophenotype for Schizophrenia.

The notion of dysconnectivity in schizophrenia has been put forward for many years and results in substantial attempts to explore altered functional connectivity (FC) within different networks with inconsistent results. Clinical, demographical, and methodological heterogeneity may contribute to the inconsistency. Forty-four patients with first-episode, drug-naive schizophrenia, 42 unaffected siblings of schizophrenia patients and 44 healthy controls took part in this study. Global-brain FC (GFC) was employed to analyze the imaging data. Compared with healthy controls, patients with schizophrenia and unaffected siblings shared enhanced GFC in the left superior frontal gyrus (SFG). In addition, patients had increased GFC mainly in the thalamo-cortical network, including the bilateral thalamus, bilateral posterior cingulate cortex (PCC)/precuneus, left superior medial prefrontal cortex (MPFC), right angular gyrus, and right SFG/middle frontal gyrus and decreased GFC in the left ITG/cerebellum Crus I. No other altered GFC values were observed in the siblings group relative to the control group. Further ROC analysis showed that increased GFC in the left SFG could separate the patients or the siblings from the controls with acceptable sensitivities. Our findings suggest that increased GFC in the left SFG may serve as a potential endophenotype for schizophrenia.

Regional white matter volume abnormalities in first-episode somatization disorder.

BACKGROUND: Alterations of white matter integrity have been implicated in patients with somatization disorder (SD). However, changes of white matter volume (WMV) remain unclear. This study is designed to examine regional WMV in patients with SD and to investigate the potential relationships between WMV abnormalities and personality traits, cognitive function, and symptom severity. METHODS: We recruited 25 first-episode, drug-naive patients with SD and 28 sex-, age-, and education-matched healthy controls for the study. Personality traits, cognitive function, and symptom severity were assessed for all participants. Data were analyzed with the computational anatomy toolbox (CAT12) methods. RESULTS: Patients with SD exhibited a significantly increased WMV in the right inferior frontal gyrus (IFG) (t = 4.4009) and a significantly decreased WMV in the left inferior longitudinal fasciculus (ILF) (t = -3.4292) relative to healthy controls. No correlation was found between abnormal WMV and clinical/cognitive variables in the patients. CONCLUSIONS: Our findings suggest the presence of significant regional WMV abnormalities in first-episode, drug-naive patients with SD, which might improve understanding the pathophysiology of SD.

Disrupted asymmetry of inter- and intra-hemispheric functional connectivity in patients with drug-naive, first-episode schizophrenia and their unaffected siblings.

BACKGROUND: Lack of normal asymmetry in the brain has been reported in patients with schizophrenia. However, it remains unclear whether disrupted asymmetry originates from inter-hemispheric functional connectivity (FC) and/or intra-hemispheric FC in this patient population. METHODS: Forty-four patients with drug-naive, first-episode schizophrenia, 42 unaffected siblings, and 44 healthy controls underwent resting-state functional magnetic resonance imaging (fMRI) scan. The parameter of asymmetry (PAS) and support vector machine (SVM) were used to analyze the data. Patients were treated with olanzapine for 8 weeks. FINDINGS: Compared with healthy controls, patients showed lower PAS scores in the left middle temporal gyrus (MTG)/inferior temporal gyrus (ITG), left posterior cingulate cortex (PCC)/precuneus and left angular gyrus, and higher PAS scores in the left precentral gyrus/postcentral gyrus. Unaffected siblings also showed lower PAS scores in the left MTG/ITG and left PCC/precuneus relative to healthy controls. Further, SVM analysis showed that a combination of the PAS scores in these two clusters in patients at baseline was able to predict clinical response after 8 weeks of olanzapine treatment with 77.27% sensitivity, 72.73% specificity, and 75.00% accuracy. INTERPRETATION: The present study suggests disrupted asymmetry of inter- and intra-hemispheric FC in drug-naive, first-episode schizophrenia; in addition, a reduced asymmetry of inter-hemispheric FC in the left MTG/ITG and left PCC/precuneus may serve as an endophenotype for schizophrenia, and may have clinical utility to predict response to olanzapine treatment. FUND: The National Key R&D Program of China and the National Natural Science Foundation of China.

Bidirectional Causal Connectivity in the Cortico-Limbic-Cerebellar Circuit Related to Structural Alterations in First-Episode, Drug-Naive Somatization Disorder.

Background: Anatomical and functional deficits in the cortico-limbic-cerebellar circuit are involved in the neurobiology of somatization disorder (SD). The present study was performed to examine causal connectivity of the cortico-limbic-cerebellar circuit related to structural deficits in first-episode, drug-naive patients with SD at rest. Methods: A total of 25 first-episode, drug-naive patients with SD and 28 healthy controls underwent structural and resting-state functional magnetic resonance imaging. Voxel-based morphometry and Granger causality analysis (GCA) were used to analyze the data. Results: Results showed that patients with SD exhibited decreased gray matter volume (GMV) in the right cerebellum Crus I, and increased GMV in the left anterior cingulate cortex (ACC), right middle frontal gyrus (MFG), and left angular gyrus. Causal connectivity of the cortico-limbic-cerebellar circuit was partly affected by structural alterations in the patients. Patients with SD showed bidirectional cortico-limbic connectivity abnormalities and bidirectional cortico-cerebellar and limbic-cerebellar connectivity abnormalities. The mean GMV of the right MFG was negatively correlated with the scores of the somatization subscale of the symptom checklist-90 and persistent error response of the Wisconsin Card Sorting Test (WCST) in the patients. A negative correlation was observed between increased driving connectivity from the right MFG to the right fusiform gyrus/cerebellum IV, V and the scores of the Eysenck Personality Questionnaire extraversion subscale. The mean GMV of the left ACC was negatively correlated with the WCST number of errors and persistent error response. Negative correlation was found between the causal effect from the left ACC to the right middle temporal gyrus and the scores of WCST number of categories achieved. Conclusions: Our findings show the partial effects of structural alterations on the cortico-limbic-cerebellar circuit in first-episode, drug-naive patients with SD. Correlations are observed between anatomical alterations or causal effects and clinical variables in patients with SD, and bear clinical significance. The present study emphasizes the importance of the cortico-limbic-cerebellar circuit in the neurobiology of SD.

Increased coherence-based regional homogeneity in resting-state patients with first-episode, drug-naive somatization disorder.

BACKGROUND: Abnormal neural activity has been observed in patients with somatization disorder (SD), especially in brain regions of the default-mode network (DMN). In this study, a coherence-based regional homogeneity (Cohe-ReHo) approach was used to detect abnormal regional synchronization in patients with SD, which might be used to differentiate the patients from the controls. METHODS: We recruited 25 patients with SD and 28 healthy controls. The imaging data of the participants were analyzed using the Cohe-ReHo approach. LIBSVM (a library for support vector machines) was utilized to verify whether abnormal Cohe-ReHo values could be applied to separate patients with SD from healthy controls. RESULTS: Compared with healthy controls, patients with SD showed an increased Cohe-ReHo in the left medial prefrontal cortex/anterior cingulate cortex (MPFC/ACC) (t = 5.5017, p < 0.001). No correlations were detected between the increased Cohe-ReHo values and clinical variables of the patients. The Cohe-ReHo values in the left MPFC/ACC could be applied to distinguish patients from controls with a sensitivity and a specificity of 84.00% and 85.71%, respectively. CONCLUSIONS: An increased Cohe-ReHo was observed in the anterior DMN of the patients and could be applied as a marker to distinguish patients from healthy controls. These results highlighted the importance of the DMN in the pathophysiology of SD.

Decreased interhemispheric functional connectivity in insula and angular gyrus/supramarginal gyrus: Significant findings in first-episode, drug-naive somatization disorder.

Neuroimaging data have demonstrated brain functional alterations in patients with somatization disorder (SD). However, there is little information on interhemispheric resting-state functional connectivity (FC) in SD. In this study, resting-state functional magnetic resonance imaging (fMRI) and voxel-mirrored homotopic connectivity (VMHC) were applied to examine the changes of interhemispheric FC of the whole brain in patients with SD. A total of 25 first-episode, medication-naive SD patients and 28 age-, sex-, education-matched healthy controls (HC) underwent resting-state fMRI, and the data were analyzed by VMHC. Compared with HC, patients had lower VMHC in the angular gyrus/supramarginal gyrus (AG/SG) and insula. The reproducibility of the results was validated using the split-half and leave-one-out validations. No significant correlation was found between the VMHC in AG/SG or insula and clinical variables. Our findings indicate that the interhemispheric FC in the AG/SG and insula is decreased in first-episode, treatment-naive patients with SD, and thus provide new insight for disruption of interhemispheric FC in the pathophysiological mechanism of SD.

Abnormal default-mode network homogeneity and its correlations with personality in drug-naive somatization disorder at rest.

BACKGROUND: While the default-mode network (DMN) appears to play a crucial role in patients suffering from somatization disorder (SD), the abnormalities of the network homogeneity (NH) of the DMN in SD patients have been poorly explored. The aim of this study is to examine DMN NH using an NH approach in patients suffering from SD at rest and determine its correlations with personality as measured by the Eysenck Personality Questionnaire (EPQ). METHODS: A total of 25 drug-naive patients with SD and 28 sex-, age-, and education-matched healthy controls underwent functional magnetic resonance imaging scans at rest. The data were analyzed by an automated NH method. RESULTS: Patients showed increased NH in the left superior frontal gyrus and decreased NH in the bilateral precuneus. Moreover, a significantly negative correlation was observed between the NH values in the bilateral precuneus and the EPQ--Neuroticism scores. LIMITATIONS: The present study should be considered preliminary due to a lenient, uncorrected threshold of p<0.01. CONCLUSIONS: The results suggest that abnormal DMN NH exists in drug-naive SD and further highlight the importance of the DMN in the pathophysiology of SD.

Abnormal regional homogeneity and its correlations with personality in first-episode, treatment-naive somatization disorder.

BACKGROUND: Structural and functional abnormalities of the default mode network (DMN) and their correlations with personality have been found in somatization disorder (SD). However, no study is conducted to identify regional neural activity and its correlations with personality in SD. In this study, regional homogeneity (ReHo) was applied to explore whether abnormal regional neural activity is present in patients with SD and its correlations with personality measured by Eysenck Personality Questionnaire (EPQ). METHODS: Twenty-five first-episode, treatment-naive patients with SD and 28 sex-, age-, and education-matched healthy controls participated in the whole study. During the scanning, all subjects were instructed to lie still with their eyes closed and remain awake. A ReHo approach was employed to analyze the data. RESULTS: The SD group had a significantly increased ReHo in the left angular gyrus (AG) compared to healthy controls. The increased ReHo positively correlated to the neuroticism scores of EPQ (EPQ-N). No other correlations were detected between the ReHo values and other related factors, such as symptom severity and education level. CONCLUSIONS: Our results suggest that abnormal regional neural activity of the DMN may play a key role in SD with clinical implications and emphasize the importance of the DMN in the pathophysiological process of SD.

Increased functional connectivity strength of right inferior temporal gyrus in first-episode, drug-naive somatization disorder.

BACKGROUND: Evidence of brain structural and functional alterations have been implicated in patients with somatization disorder (SD). However, little is known about brain functional connectivity in SD. In the present study, resting-state functional magnetic resonance imaging (fMRI) and graph theory were used to obtain a comprehensive view of whole-brain functional connectivity and to investigate the changes of voxel-wise functional networks in patients with SD. METHODS: Twenty-five first-episode, medication-naive patients with SD and 28 age-, sex- and education-matched healthy controls (HCs) underwent resting-state fMRI. The graph theory approach was employed to analyze the data. RESULTS: Compared to the HCs, patients with SD showed significantly increased functional connectivity strength in the right inferior temporal gyrus (ITG). There is a significant positive correlation between the z-values of the cluster in the right ITG and Hamilton Anxiety Scale scores. CONCLUSIONS: Our findings indicate that there is a disruption of the functional connectivity pattern in the right ITG in first-episode, treatment-naive patients with SD, which bears clinical significance.

Decreased default-mode network homogeneity in unaffected siblings of schizophrenia patients at rest.

The dysconnectivity hypothesis proposes that abnormal resting state connectivity within the default-mode network (DMN) plays a key role in schizophrenia. Little is known, however, about alterations of the network homogeneity (NH) of the DMN in unaffected siblings of patients with schizophrenia. Unaffected siblings have unique advantages as subjects of neuroimaging studies independent of the clinical and treatment issues that complicate studies of the patients themselves. In the present study, we investigated NH of the DMN in unaffected siblings of schizophrenia. Participants comprised 46 unaffected siblings of schizophrenia patients and 50 age-, sex-, and education-matched healthy controls who underwent resting state functional magnetic resonance imaging (fMRI). Automated NH and group independent component analysis (ICA) approaches were used to analyze the data. Compared with healthy controls, the unaffected siblings of schizophrenia patients showed decreased DMN homogeneity in the left precuneus. No significantly increased DMN homogeneity was found in the sibling group relative to the control group. Our results suggest that there is decreased NH of the DMN in unaffected siblings of schizophrenia patients and indicate that the alternative perspective of examining the DMN NH in patients׳ siblings may improve understanding of the nature of schizophrenia.