Differences of regional homogeneity and cognitive function between psychotic depression and drug-naïve schizophrenia

Differences of regional homogeneity and cognitive function between psychotic depression and drug-naïve schizophrenia | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Differences of regional homogeneity and cognitive function between psychotic depression and drug-naïve schizophrenia Wensheng Chen, Xiaoling Li, Weibin wu, Wenxuan Li, Wei Huang, and 6 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-2856800/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Psychotic depression (PD) and schizophrenia (SCZ) are disorders with shared symptoms but unique causes, development, and treatments. Identifying them based on symptoms is difficult, requiring deeper comprehension of cognitive and neural mechanisms for accurate diagnosis and treatment. Aim: This study aims to compare cognitive impairments and brain functional activities in PD and SCZ, in order to identify unique features of each disorder. Methods: We studied 42 PD and 30 SCZ patients using RBANS and rs-fMRI. We computed ReHo values from the rs-fMRI data and compared RBANS scores between groups. We also investigated the correlation between cognition and brain function using Pearson analysis. Results: (1) SC group had lower RBANS scores than PD group in all test sections; (2) Left precuneus had significant ReHo difference between PD and SC groups, with SCZ group showing significantly increased ReHo (p < 0.05); (3) Negative correlation found between visuospatial construction score, delayed memory score and ReHo value of left precuneus by Pearson correlation analysis. conclusion: Cognitive impairment is more severe in SCZ than PD. Elevated left precuneus activity distinguishes PD from SCZ and relates to cognitive deficits in both, offering neuroimaging evidence for differential diagnosis and insight into cognitive impairment pathology. Biological sciences/Neuroscience/Cognitive neuroscience Biological sciences/Neuroscience/Emotion Biological sciences/Neuroscience/Neurogenesis Health sciences/Neurology/Neurological disorders Psychotic depression Schizophrenia ReHo Rs-fMRI Cognition 1. Introduction Schizophrenia (SCZ) is a persistent and disabling mental disorder that affects 1% of the global population, typically characterized by a range of positive, negative, and cognitive symptoms 1 , 2 . To what extent schizophrenia disrupts an individual's functioning in daily life varies. Some are able to perform at a high level, including work and social abilities, while others experience severe disability due to the severity of their symptoms 3 . Research findings suggest that schizophrenia psychosis is most common in the late adolescence and early adulthood, in the second and third decades of life 4 . That is to say, schizophrenia is often accompanied by significant declines in social and cognitive functioning rather than presenting solely as psychosis 5 , 6 . Although hallucinations and delusions, which are a hallmark of the disease, are the most recognizable symptoms, several studies indicate that cognitive deficits typically manifest before the onset of psychosis and serve as a dependable prognostic indicator for long-term social functioning outcomes 7 , 8 . Therefore, an increasing number of studies have placed increasing emphasis on investigating cognitive impairments in schizophrenia 9 , 10 . Major Depressive Disorder (MDD) with psychotic features (psychotic depression, PD) is a severe disabling illness with a high risk of suicide 11 , 12 . It is characterized by meeting the criteria for severe depression and exhibiting psychotic features such as hallucinations or delusions during a major depressive episode. Symptoms often include nihilistic delusions, excessive self-criticism, or beliefs of guilt 13 . Epidemiological studies of PD have found that the lifetime prevalence of PD varies between 0.35% and 1%, with higher rates observed in the elderly population 14 . Research on cognitive impairment in depression has revealed that PD tends to exhibit more severe symptoms compared to non-psychotic depression 15 – 17 . Moreover, among young adult patients with PD, they demonstrated, on average, worse cognitive performance across all cognitive domains compared to those who only have depression without psychotic features 18 , 19 . SCZ and PD are two mental disorders that share common features of psychotic symptoms, such as delusions, hallucinations, or both, as well as severe impairment in occupational functioning. Compared to non-psychotic major depression patients and healthy controls, patients with PD exhibited more severe cognitive impairments in attention, cognitive inhibition, and verbal memory 15 , 20 . At present, there is no consensus on whether there are cognitive differences between patients with SCZ and PD. It is worth noting that while both disorders share some clinical similarities, there are distinct differences in their cognitive symptoms and neural mechanisms, which can lead to diagnostic confusion in clinical practice. The search for neurobiological markers to aid in the diagnosis and differentiation of these two disorders has long been a focus of research efforts. Resting-state functional magnetic resonance imaging (rs-fMRI) is a non-invasive neuroimaging technique that has become an important tool for investigating functional connectivity in the brain, particularly in the context of psychiatric disorders 21 , 22 . Regional homogeneity (ReHo) is a metric that assesses the degree of similarity between the time series of a particular voxel and those of its closest neighboring voxels within a single region of the brain, and is a valuable indicator of local temporal synchrony in the brain 23 . The ReHo method is a dependable tool for assessing brain activity, which can be utilized to explore alterations in brain function resulting from both normal development and pathological states. According to this method, previous studies have indicated the presence of widespread ReHo abnormalities in mental disorders. For example, compared to healthy controls, patients with schizophrenia exhibit increased ReHo values in the right frontal cortex 24 or in regions of the somatosensory and perception networks 25 , and decreased ReHo values in regions of the visual cortex 26 . However, to our knowledge, there is currently no research on ReHo in psychotic depression. In light of this, we employed a combination of cognitive function assessment and functional imaging techniques to investigate cognitive impairment and neuroimaging differences between drug-naïve patients with SCZ and PD. The goal of this study was to provide a theoretical foundation for the clinical diagnosis and differentiation of these two disorders. 2. Method 2.1 Participants From January 2019 to October 2022, SCZ/PD patients who received treatment in the Department of Psychiatry at the Third People's Hospital of Foshan, China, were included in this study, regardless of whether they were inpatients or outpatients. Clinically relevant information was obtained through interviews with clinicians. Inclusion criteria were as follows: (1) a diagnosis of SCZ/PD based on the criteria of the Structured Clinical Interview for DSM-IV-TR (SCID); (2) aged between 18 and 45 years; (3) education of at least 9 years; (4) Han ethnicity and right-handedness; (5) drug-naïve and a disease course of ≤ 2 years from the time of initial diagnosis. Exclusion criteria included the presence of other mental illnesses, brain organic and physical disorders, a family history of mental illness, substance abuse (drugs, alcohol), brain trauma, neurological diseases, and so on. All participants volunteered to take part in this study and were screened for contraindications to magnetic resonance imaging (MRI). We obtained written informed consent from each patient before conducting the MRI scan. This study was approved by the ethics committee of the Third People's Hospital of Foshan and conducted in accordance with the principles of the Declaration of Helsinki. 2.2 Assessments Scale evaluations were conducted using the following methods: (1) The Positive and Negative Syndrome Scale (PANSS) 27 was utilized to assess SC symptoms, while the Hamilton Depression Scale-24 items (HAMD) 28 was used to evaluate the PD group. (2) Cognitive function was assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) 29 . The subjects were provided with standardized instructions and guidance regarding the evaluation rules. 2.3 Imaging Data Acquisition Rs-fMRI was conducted using a Signa Pioneer 3.0T MR scanner from General Electric Company in the United States. Participants were instructed to remain supine with their eyes closed and to maintain a clear level of consciousness throughout the scan. T1-weighted structural images were acquired using the following scanning parameters: repetition time (TR) = 2000 ms, echo time (TE) = 30 ms, flip angle (FA) = 90º, field of view (FOV) = 240 mm × 240 mm, matrix = 64 × 64, slice thickness = 4 mm, gap = 1 mm, and 250 continuous time points were collected. High-resolution T1-weighted images were acquired using the following parameters: TR = 8.6 ms, TE = 3.3 ms, FA = 12°, FOV = 256 mm × 256 mm, matrix = 256 × 256, slice thickness = 1 mm, no gap between slices, and a total of 172 slices. Data preprocessing: DPARSF system ( http://www.restfmri.net ) was used to preprocess all image data. The first 10 sequences of images were deleted to exclude the influence of machine start-up on signal collection, and the remaining 240 sequences were used for data analysis. The preprocessing process included head movement correction and spatial standardization. According to the head movement correction curve, the data of 5 subjects with head movement translation > 2mm and rotation > 2.5° were eliminated. The resting functional image was re-registered with T1 image, and then the imaging data were normalized to the Montreal Neurological Institute (MNI) space, and resampled to 3mm * 3mm * 3mm resolution. 2.4 ReHo analysis ReHo analysis was performed using a 27-voxel cluster size, and the Kendall coefficient of concordance (KCC) was used as an indicator to measure the local consistency of each voxel and its 26 nearest neighbors. The default standard brain model provided by the DPARSF software was used to obtain KCC maps for each subject. The KCC values were standardized by dividing them by the mean value in the standard brain model. The resulting mReHo maps were then spatially smoothed. 2.5 Statistical Analysis The clinical scale scores were analyzed using SPSS 20 ( https://www.ibm.com/analytics/spss-statistics-software ). The normal distribution of measurement data from both the SCZ and HC groups was confirmed using the Kolmogorov-Smirnov (K-S) test. Two-sample t-tests were conducted on standardized ReHo images using SPM 8 software ( https://www.fil.ion.ucl.ac.uk/spm/software/spm8 ). The mean values of head motion parameters, gender, age, and years of education were included as covariates in the analysis. Pearson correlation analysis was then performed to investigate the relationship between cognitive function scores and ReHo values in different brain regions. Finally, p values were corrected for multiple comparisons using false discovery rate (FDR) correction. (Fig. 1 ) 3. Result 3.1 Clinical data and cognitive function test This study included a total of 84 participants, including 42 patients with PD, and 35 patients with SCZ. Due to symptoms such as claustrophobia exhibited by 5 patients with SCZ who did not cooperate with the examination, they were excluded from the group. Gender distribution did not significantly differ between the PD and SCZ groups (p > 0.05). However, significant differences were observed in age, years of education, course of disease, and various cognitive domains of the RBANS test, including immediate memory (learning and story memory), visuospatial construction, language, attention (digit span), and delayed memory (list recall, list recognition, story recall, and figure recall) (p < 0.05). Overall, the cognitive function of SC patients was found to be lower than that of PD patients (p < 0.05). Please refer to Table 1 for detailed information. Table 1 Clinical data and RBANS test between PD and SC PD SCZ Χ 2 / t p Participants 42 30 - - Age (years) 37.633 ± 10.039 26.714 ± 11.589 21.798 < 0.001 Gender (m/f) 17 / 25 14 / 16 0.274 0.601 Education 12.771 ± 3.059 10.366 ± 3.134 28.499 < 0.001 HAMD 25.047 ± 5.323 - - - PANSS - 77.466 ± 16.596 - - RBANS Immediate memory (Learning) 27.487 ± 6.237 18.400 ± 6.815 25.323 < 0.001 Immediate memory (Story Memory) 13.609 ± 5.761 6.000 ± 4.623 13.489 < 0.001 Visuospatial Construction 18.658 ± 2.128 16.200 ± 4.188 44.062 < 0.001 Language 17.365 ± 4.515 11.066 ± 4.578 22.563 < 0.001 Attention (Digit span) 13.951 ± 2.626 11.100 ± 2.577 36.400 < 0.001 Attention (Coding) 47.292 ± 12.613 25.866 ± 12.778 19.530 < 0.001 Delayed memory (List Recall) 6.439 ± 2.966 3.100 ± 2.695 12.893 < 0.001 Delayed memory (List Recognition) 19.536 ± 1.074 17.133 ± 3.329 60.374 < 0.001 Delayed memory (Story Recall) 7.750 ± 3.739 3.166 ± 2.640 12.081 < 0.001 Delayed memory (Figure Recall) 14.075 ± 4.034 9.200 ± 6.155 18.002 < 0.001 Note: PD psychotic depression; SCZ schizophrenia; HAMD Hamilton Depression Scale-24items; PANSS Positive and Negative Syndrome Scale; RBANS Repeatable Battery for the Assessment of Neuropsychological Status; Values are expressed as mean ± standard deviation. 3.2 ReHo Compared with SCZ, the brain areas with significant differences in PD were the left precuneus (Peak coordinates of − 9, − 72, 39; t = 5.634, voxel size = 27, p < 0.05, GRF correction, two-tailed). (Fig. 2 ) 3.3 Pearson correlation analysis The ReHo values of the left precuneus were negatively correlated with visuospatial construction and delayed memory (List recognition) score ( r visuospatial construction = -0.287, p = 0.015; r delayed memory (List Recognition) = -0.256, p = 0.031). (Fig. 3 ) 4. Discussion The results of this study showed that SCZ patients had lower cognitive function than PD patients. Compared to PD patients, SCZ patients had higher ReHo values in the left precuneus. Furthermore, the left precuneus ReHo values were negatively correlated with visuospatial construction and delayed memory (list recognition) scores, indicating that SCZ patients performed worse than PD patients in terms of visuospatial construction and delayed memory. In both SCZ and PD, cognitive impairments are a common symptom 30 – 33 . However, there are differences in cognitive impairments between these two disorders. Cognitive impairments in patients with SCZ typically manifest as more severe deficits in attention, working memory, executive function, and inhibitory control 34 , 35 . Additionally, individuals with SCZ may experience disturbances or disorders of consciousness, which can have a significant impact on cognitive functioning 36 . In contrast, the severity of cognitive impairments in patients with PD may be relatively mild 14 . Additionally, patients may exhibit impairments in working memory, executive function, and inhibitory control. Individuals with PD typically maintain a clear level of consciousness and do not experience disturbances or disorders of consciousness 37 , 38 . Our study indicates that the cognitive test scores of individuals with SCZ were lower than those of individuals with PD, which is consistent with previous research and suggests that cognitive impairments in SC are more severe than in PD. The study demonstrates that cognitive function can be significantly improved in PD patients as depressive symptoms subside 39 . However, cognitive impairment in SC is generally considered irreversible as it is believed to be related to neural damage 40 , 41 . Therefore, cognitive testing can be helpful in distinguishing between the diagnoses of these two diseases. Our study demonstrated that compared to PD, SCZ had higher ReHo values in the left precuneus. The precuneus, located in the posterior superior region of the cerebral hemisphere, is a major functional area of the brain involved in various cognitive functions such as spatial perception, visual-spatial processing, memory, emotion, and consciousness 42 – 44 . In neuroscience research, the functional activity of the precuneus is frequently measured and explored, and it is also often of interest in studies of psychiatric disorders 45 – 48 . The activation of the precuneus is associated with the vividness of judgments during episodic memory retrieval 49 . Research has demonstrated that individuals with schizophrenia who experience auditory verbal hallucinations exhibit increased spontaneous neural activity in the left precuneus region compared to healthy controls, resulting in elevated ReHo values 50 . Our research findings also support this conclusion, as we have found that the more severe the cognitive impairment, the more prominent the neural activity in the left precuneus. The left precuneus is a central brain region of the default mode network (DMN) and an important hub of the resting-state brain connectivity network that underlies human cognitive functions. Therefore, changes in the functional connectivity of the left precuneus may serve as an indicator to differentiate between cognitive impairments in patients with SCZ and those with PD. We conducted a correlation analysis between the cognitive scores in RBANS and the ReHo values of the left precuneus. The results showed a significant negative correlation between the scores of visuospatial construction and delayed memory and the abnormal activity in this brain region. Research has found that patients with SCZ exhibit abnormal behavioral patterns and inflexible eye movement strategies in visuospatial problem-solving tasks 51 . And other researches had shown that patients with SCZ exhibit significant declines in visual spatial ability 52 – 54 , as well as significant deterioration in delayed memory 55 , 56 . This leads to a poorer prognosis for SCZ 57 and may be one of the factors contributing to the worse prognosis of SCZ compared to PD. As is well known, the precuneus is one of the main integration centers of functional and structural processes in the human brain, playing an important role in visual-spatial integration, memory, and self-awareness. At the same time, it also links visual information with other brain processing systems involved in executive functions. Research has shown that when patients have focal brain damage in the precuneus, their cognitive function can be impaired to varying degrees 42 , 58 , which further supports our point. In summary, cognitive function tests can serve as an important indicator of differences between PD and SCZ in clinical practice. Abnormal activity in the left precuneus may be a core brain region that distinguishes PD from SCZ and is closely related to cognitive impairment. This provides neuroimaging evidence for clinical differential diagnosis and sheds light on the pathological mechanisms underlying cognitive impairment. There are some limitations in this study. Firstly, in order to minimize the possibility of diagnostic errors, we only selected PD and SCZ patients with a disease duration of more than 2 years and excluded SCZ patients who could not cooperate, which may result in selection bias. Secondly, this study used a cross-sectional observational design, which cannot determine causality of the observed differences and requires longer-term longitudinal studies. Finally, due to the small sample size of available studies, further research is needed to explore the clinical and functional relevance of cluster members. Therefore, future studies should use more rigorous designs and large sample sizes to validate our results and explore the pathological mechanisms of cognitive differences in PD and SCZ patients. Declarations Acknowledgments Not applicable. Conflict of Interest The authors have no potential or actual conflicts of interest. Funding This study was supported by the project of Foshan Science and Technology Bureau (2220001004473, 2220001004879) and the Foshan "14th five-year plan" medical high level key psychiatric specialty construction project (FSGSP145069). Data Availability Statement The datasets generated and/or analyzed during the current study are not publicly available due to confidentiality but are available from the corresponding author on reasonable request. Author Contribution Wensheng Chen, Xiaoling Li, Chunguo Zhang, and Jiaquan Liang have made great contributions to the conception, design and writing of the works; Other authors have provided assistances in the acquisition, analysis, or interpretation of data. References Owen, M. J., Sawa, A. & Mortensen, P. B. Schizophrenia. Lancet 388, 86–97, doi: 10.1016/S0140-6736(15)01121-6 (2016). Lewis, D. A. & Lieberman, J. A. Catching up on schizophrenia: natural history and neurobiology. Neuron 28, 325–334, doi: 10.1016/s0896-6273(00)00111-2 (2000). 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Neuropsychiatr Dis Treat 18, 2991–3000, doi: 10.2147/NDT.S393586 (2022). Li, Z. et al. NRG3 contributes to cognitive deficits in chronic patients with schizophrenia. Schizophr Res 215, 134–139, doi: 10.1016/j.schres.2019.10.060 (2020). Yeager, B. E. et al. Central precuneus lesions are associated with impaired executive function. Brain Struct Funct 227, 3099–3108, doi: 10.1007/s00429-022-02556-0 (2022). Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-2856800","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":195643863,"identity":"94400762-afc9-484b-bdfb-84b49a9c5c71","order_by":0,"name":"Wensheng Chen","email":"","orcid":"","institution":"Department of Psychiatry, The Third People's Hospital of Foshan, Foshan","correspondingAuthor":false,"prefix":"","firstName":"Wensheng","middleName":"","lastName":"Chen","suffix":""},{"id":195643864,"identity":"3ad847f2-b300-40e0-8912-2d5f684429a9","order_by":1,"name":"Xiaoling Li","email":"","orcid":"","institution":"Department of Psychiatry, The Third People's Hospital of Foshan, Foshan","correspondingAuthor":false,"prefix":"","firstName":"Xiaoling","middleName":"","lastName":"Li","suffix":""},{"id":195643865,"identity":"42ea2bcf-6b63-4b14-b66d-8d9d2e785a07","order_by":2,"name":"Weibin wu","email":"","orcid":"","institution":"Department of Psychiatry, The Third People's Hospital of Foshan, Foshan","correspondingAuthor":false,"prefix":"","firstName":"Weibin","middleName":"","lastName":"wu","suffix":""},{"id":195643866,"identity":"8a83fdb8-1b47-4a69-917a-855b01da474d","order_by":3,"name":"Wenxuan Li","email":"","orcid":"","institution":"Department of Psychiatry, The Third People's Hospital of Foshan, Foshan","correspondingAuthor":false,"prefix":"","firstName":"Wenxuan","middleName":"","lastName":"Li","suffix":""},{"id":195643867,"identity":"8c018ab5-5503-4c49-a1dc-6ef6ebd5efc4","order_by":4,"name":"Wei Huang","email":"","orcid":"","institution":"Department of Psychiatry, The Third People's Hospital of Foshan, Foshan","correspondingAuthor":false,"prefix":"","firstName":"Wei","middleName":"","lastName":"Huang","suffix":""},{"id":195643868,"identity":"a24bb26a-890e-470d-8ab5-38e5ab035692","order_by":5,"name":"Zhijian Li","email":"","orcid":"","institution":"Department of Psychiatry, The Third People's Hospital of Foshan, Foshan","correspondingAuthor":false,"prefix":"","firstName":"Zhijian","middleName":"","lastName":"Li","suffix":""},{"id":195643869,"identity":"7951bde8-1b0a-492e-ab0d-134984220918","order_by":6,"name":"Caixia Xu","email":"","orcid":"","institution":"Department of Psychiatry, The Third People's Hospital of Foshan, Foshan","correspondingAuthor":false,"prefix":"","firstName":"Caixia","middleName":"","lastName":"Xu","suffix":""},{"id":195643870,"identity":"c043264d-c734-4824-8654-551be36d92dc","order_by":7,"name":"Guojun Xie","email":"","orcid":"","institution":"Department of Psychiatry, The Third People's Hospital of Foshan, Foshan","correspondingAuthor":false,"prefix":"","firstName":"Guojun","middleName":"","lastName":"Xie","suffix":""},{"id":195643871,"identity":"762d9a3a-6931-4129-83e2-753c1b85f4a5","order_by":8,"name":"Xuesong Li","email":"","orcid":"","institution":"Department of Psychiatry, The Third People's Hospital of Foshan, Foshan","correspondingAuthor":false,"prefix":"","firstName":"Xuesong","middleName":"","lastName":"Li","suffix":""},{"id":195643872,"identity":"1ab1f342-821a-4b60-8486-acc181f151d4","order_by":9,"name":"Chunguo Zhang","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA5ElEQVRIiWNgGAWjYHACNhDBw8/ekPggoaKGeC0ykj0HHhs8OHOMeC02BjcSn0k+bGEmrJ6/f/mzBz931PIY3EhOq0hsYGPgb+9OwKtF4saDdMPeM8d5JM88S7uRuEOGQeLM2Q14tRhIHDgmwdt2jIfveA5Qyxk2oEguIS0H2yT/ArUwHMj/VpDYxkyEFv5mNmnethoegRMJaQxEaZG4wcYmLdt2gAcYyMkSCWeO8RD0C3//8WeSb9vq7EFR+fFHRY0cf3svfi0MEgkg8jCcz4NfOdiaAyCyjrDCUTAKRsEoGLkAAHPHTmWYxlLIAAAAAElFTkSuQmCC","orcid":"","institution":"Department of Psychiatry, The Third People's Hospital of Foshan, Foshan","correspondingAuthor":true,"prefix":"","firstName":"Chunguo","middleName":"","lastName":"Zhang","suffix":""},{"id":195643873,"identity":"4d0e87ad-a742-4ec9-b955-578604af6144","order_by":10,"name":"Jiaquan Liang","email":"","orcid":"","institution":"The Third People’s Hospital of Foshan","correspondingAuthor":false,"prefix":"","firstName":"Jiaquan","middleName":"","lastName":"Liang","suffix":""}],"badges":[],"createdAt":"2023-04-25 01:29:24","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-2856800/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-2856800/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":43091718,"identity":"23612bdc-4b25-4ec0-95c5-dc684c936834","added_by":"auto","created_at":"2023-09-13 20:07:25","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":276101,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-2856800/v1/04939f0b-4f64-42eb-83d1-d9a033bd287a.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Differences of regional homogeneity and cognitive function between psychotic depression and drug-naïve schizophrenia","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eSchizophrenia (SCZ) is a persistent and disabling mental disorder that affects 1% of the global population, typically characterized by a range of positive, negative, and cognitive symptoms \u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e,\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e. To what extent schizophrenia disrupts an individual's functioning in daily life varies. Some are able to perform at a high level, including work and social abilities, while others experience severe disability due to the severity of their symptoms \u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e. Research findings suggest that schizophrenia psychosis is most common in the late adolescence and early adulthood, in the second and third decades of life \u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e. That is to say, schizophrenia is often accompanied by significant declines in social and cognitive functioning rather than presenting solely as psychosis \u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e,\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e. Although hallucinations and delusions, which are a hallmark of the disease, are the most recognizable symptoms, several studies indicate that cognitive deficits typically manifest before the onset of psychosis and serve as a dependable prognostic indicator for long-term social functioning outcomes \u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e,\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e. Therefore, an increasing number of studies have placed increasing emphasis on investigating cognitive impairments in schizophrenia \u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e,\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eMajor Depressive Disorder (MDD) with psychotic features (psychotic depression, PD) is a severe disabling illness with a high risk of suicide \u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e,\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e. It is characterized by meeting the criteria for severe depression and exhibiting psychotic features such as hallucinations or delusions during a major depressive episode. Symptoms often include nihilistic delusions, excessive self-criticism, or beliefs of guilt \u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e. Epidemiological studies of PD have found that the lifetime prevalence of PD varies between 0.35% and 1%, with higher rates observed in the elderly population \u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e. Research on cognitive impairment in depression has revealed that PD tends to exhibit more severe symptoms compared to non-psychotic depression \u003csup\u003e\u003cspan additionalcitationids=\"CR16\" citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e. Moreover, among young adult patients with PD, they demonstrated, on average, worse cognitive performance across all cognitive domains compared to those who only have depression without psychotic features \u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e,\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eSCZ and PD are two mental disorders that share common features of psychotic symptoms, such as delusions, hallucinations, or both, as well as severe impairment in occupational functioning. Compared to non-psychotic major depression patients and healthy controls, patients with PD exhibited more severe cognitive impairments in attention, cognitive inhibition, and verbal memory \u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e,\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e. At present, there is no consensus on whether there are cognitive differences between patients with SCZ and PD. It is worth noting that while both disorders share some clinical similarities, there are distinct differences in their cognitive symptoms and neural mechanisms, which can lead to diagnostic confusion in clinical practice. The search for neurobiological markers to aid in the diagnosis and differentiation of these two disorders has long been a focus of research efforts.\u003c/p\u003e \u003cp\u003eResting-state functional magnetic resonance imaging (rs-fMRI) is a non-invasive neuroimaging technique that has become an important tool for investigating functional connectivity in the brain, particularly in the context of psychiatric disorders \u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e,\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e. Regional homogeneity (ReHo) is a metric that assesses the degree of similarity between the time series of a particular voxel and those of its closest neighboring voxels within a single region of the brain, and is a valuable indicator of local temporal synchrony in the brain \u003csup\u003e\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u003c/sup\u003e. The ReHo method is a dependable tool for assessing brain activity, which can be utilized to explore alterations in brain function resulting from both normal development and pathological states. According to this method, previous studies have indicated the presence of widespread ReHo abnormalities in mental disorders. For example, compared to healthy controls, patients with schizophrenia exhibit increased ReHo values in the right frontal cortex \u003csup\u003e\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u003c/sup\u003e or in regions of the somatosensory and perception networks \u003csup\u003e\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u003c/sup\u003e, and decreased ReHo values in regions of the visual cortex \u003csup\u003e\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u003c/sup\u003e. However, to our knowledge, there is currently no research on ReHo in psychotic depression.\u003c/p\u003e \u003cp\u003eIn light of this, we employed a combination of cognitive function assessment and functional imaging techniques to investigate cognitive impairment and neuroimaging differences between drug-na\u0026iuml;ve patients with SCZ and PD. The goal of this study was to provide a theoretical foundation for the clinical diagnosis and differentiation of these two disorders.\u003c/p\u003e"},{"header":"2. Method","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Participants\u003c/h2\u003e \u003cp\u003eFrom January 2019 to October 2022, SCZ/PD patients who received treatment in the Department of Psychiatry at the Third People's Hospital of Foshan, China, were included in this study, regardless of whether they were inpatients or outpatients. Clinically relevant information was obtained through interviews with clinicians. Inclusion criteria were as follows: (1) a diagnosis of SCZ/PD based on the criteria of the Structured Clinical Interview for DSM-IV-TR (SCID); (2) aged between 18 and 45 years; (3) education of at least 9 years; (4) Han ethnicity and right-handedness; (5) drug-na\u0026iuml;ve and a disease course of \u0026le;\u0026thinsp;2 years from the time of initial diagnosis. Exclusion criteria included the presence of other mental illnesses, brain organic and physical disorders, a family history of mental illness, substance abuse (drugs, alcohol), brain trauma, neurological diseases, and so on.\u003c/p\u003e \u003cp\u003eAll participants volunteered to take part in this study and were screened for contraindications to magnetic resonance imaging (MRI). We obtained written informed consent from each patient before conducting the MRI scan. This study was approved by the ethics committee of the Third People's Hospital of Foshan and conducted in accordance with the principles of the Declaration of Helsinki.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2 Assessments\u003c/h2\u003e \u003cp\u003eScale evaluations were conducted using the following methods: (1) The Positive and Negative Syndrome Scale (PANSS) \u003csup\u003e\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u003c/sup\u003e was utilized to assess SC symptoms, while the Hamilton Depression Scale-24 items (HAMD) \u003csup\u003e\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u003c/sup\u003e was used to evaluate the PD group. (2) Cognitive function was assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) \u003csup\u003e\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u003c/sup\u003e. The subjects were provided with standardized instructions and guidance regarding the evaluation rules.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e2.3 Imaging Data Acquisition\u003c/h2\u003e \u003cp\u003eRs-fMRI was conducted using a Signa Pioneer 3.0T MR scanner from General Electric Company in the United States. Participants were instructed to remain supine with their eyes closed and to maintain a clear level of consciousness throughout the scan. T1-weighted structural images were acquired using the following scanning parameters: repetition time (TR)\u0026thinsp;=\u0026thinsp;2000 ms, echo time (TE)\u0026thinsp;=\u0026thinsp;30 ms, flip angle (FA)\u0026thinsp;=\u0026thinsp;90\u0026ordm;, field of view (FOV)\u0026thinsp;=\u0026thinsp;240 mm \u0026times; 240 mm, matrix\u0026thinsp;=\u0026thinsp;64 \u0026times; 64, slice thickness\u0026thinsp;=\u0026thinsp;4 mm, gap\u0026thinsp;=\u0026thinsp;1 mm, and 250 continuous time points were collected. High-resolution T1-weighted images were acquired using the following parameters: TR\u0026thinsp;=\u0026thinsp;8.6 ms, TE\u0026thinsp;=\u0026thinsp;3.3 ms, FA\u0026thinsp;=\u0026thinsp;12\u0026deg;, FOV\u0026thinsp;=\u0026thinsp;256 mm \u0026times; 256 mm, matrix\u0026thinsp;=\u0026thinsp;256 \u0026times; 256, slice thickness\u0026thinsp;=\u0026thinsp;1 mm, no gap between slices, and a total of 172 slices. Data preprocessing: DPARSF system (\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://www.restfmri.net\u003c/span\u003e\u003cspan address=\"http://www.restfmri.net\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e) was used to preprocess all image data. The first 10 sequences of images were deleted to exclude the influence of machine start-up on signal collection, and the remaining 240 sequences were used for data analysis. The preprocessing process included head movement correction and spatial standardization. According to the head movement correction curve, the data of 5 subjects with head movement translation\u0026thinsp;\u0026gt;\u0026thinsp;2mm and rotation\u0026thinsp;\u0026gt;\u0026thinsp;2.5\u0026deg; were eliminated. The resting functional image was re-registered with T1 image, and then the imaging data were normalized to the Montreal Neurological Institute (MNI) space, and resampled to 3mm * 3mm * 3mm resolution.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e2.4 ReHo analysis\u003c/h2\u003e \u003cp\u003eReHo analysis was performed using a 27-voxel cluster size, and the Kendall coefficient of concordance (KCC) was used as an indicator to measure the local consistency of each voxel and its 26 nearest neighbors. The default standard brain model provided by the DPARSF software was used to obtain KCC maps for each subject. The KCC values were standardized by dividing them by the mean value in the standard brain model. The resulting mReHo maps were then spatially smoothed.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e2.5 Statistical Analysis\u003c/h2\u003e \u003cp\u003eThe clinical scale scores were analyzed using SPSS 20 (\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.ibm.com/analytics/spss-statistics-software\u003c/span\u003e\u003cspan address=\"https://www.ibm.com/analytics/spss-statistics-software\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e). The normal distribution of measurement data from both the SCZ and HC groups was confirmed using the Kolmogorov-Smirnov (K-S) test. Two-sample t-tests were conducted on standardized ReHo images using SPM 8 software (\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.fil.ion.ucl.ac.uk/spm/software/spm8\u003c/span\u003e\u003cspan address=\"https://www.fil.ion.ucl.ac.uk/spm/software/spm8\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e). The mean values of head motion parameters, gender, age, and years of education were included as covariates in the analysis. Pearson correlation analysis was then performed to investigate the relationship between cognitive function scores and ReHo values in different brain regions. Finally, p values were corrected for multiple comparisons using false discovery rate (FDR) correction. (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"3. Result","content":"\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003e3.1 Clinical data and cognitive function test\u003c/h2\u003e \u003cp\u003eThis study included a total of 84 participants, including 42 patients with PD, and 35 patients with SCZ. Due to symptoms such as claustrophobia exhibited by 5 patients with SCZ who did not cooperate with the examination, they were excluded from the group.\u003c/p\u003e \u003cp\u003eGender distribution did not significantly differ between the PD and SCZ groups (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05). However, significant differences were observed in age, years of education, course of disease, and various cognitive domains of the RBANS test, including immediate memory (learning and story memory), visuospatial construction, language, attention (digit span), and delayed memory (list recall, list recognition, story recall, and figure recall) (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Overall, the cognitive function of SC patients was found to be lower than that of PD patients (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Please refer to Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e for detailed information.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eClinical data and RBANS test between PD and SC\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSCZ\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eΧ\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e / \u003cem\u003et\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eParticipants\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e37.633\u0026thinsp;\u0026plusmn;\u0026thinsp;10.039\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26.714\u0026thinsp;\u0026plusmn;\u0026thinsp;11.589\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21.798\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender (m/f)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e17 / 25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14 / 16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.274\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.601\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEducation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12.771\u0026thinsp;\u0026plusmn;\u0026thinsp;3.059\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.366\u0026thinsp;\u0026plusmn;\u0026thinsp;3.134\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28.499\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHAMD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25.047\u0026thinsp;\u0026plusmn;\u0026thinsp;5.323\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePANSS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e77.466\u0026thinsp;\u0026plusmn;\u0026thinsp;16.596\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRBANS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eImmediate memory (Learning)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27.487\u0026thinsp;\u0026plusmn;\u0026thinsp;6.237\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18.400\u0026thinsp;\u0026plusmn;\u0026thinsp;6.815\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25.323\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eImmediate memory (Story Memory)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13.609\u0026thinsp;\u0026plusmn;\u0026thinsp;5.761\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.000\u0026thinsp;\u0026plusmn;\u0026thinsp;4.623\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.489\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVisuospatial Construction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18.658\u0026thinsp;\u0026plusmn;\u0026thinsp;2.128\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16.200\u0026thinsp;\u0026plusmn;\u0026thinsp;4.188\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e44.062\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLanguage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e17.365\u0026thinsp;\u0026plusmn;\u0026thinsp;4.515\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11.066\u0026thinsp;\u0026plusmn;\u0026thinsp;4.578\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22.563\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAttention (Digit span)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13.951\u0026thinsp;\u0026plusmn;\u0026thinsp;2.626\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11.100\u0026thinsp;\u0026plusmn;\u0026thinsp;2.577\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e36.400\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAttention (Coding)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e47.292\u0026thinsp;\u0026plusmn;\u0026thinsp;12.613\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25.866\u0026thinsp;\u0026plusmn;\u0026thinsp;12.778\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19.530\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDelayed memory (List Recall)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6.439\u0026thinsp;\u0026plusmn;\u0026thinsp;2.966\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.100\u0026thinsp;\u0026plusmn;\u0026thinsp;2.695\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.893\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDelayed memory (List Recognition)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e19.536\u0026thinsp;\u0026plusmn;\u0026thinsp;1.074\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17.133\u0026thinsp;\u0026plusmn;\u0026thinsp;3.329\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e60.374\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDelayed memory (Story Recall)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7.750\u0026thinsp;\u0026plusmn;\u0026thinsp;3.739\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.166\u0026thinsp;\u0026plusmn;\u0026thinsp;2.640\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.081\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDelayed memory (Figure Recall)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14.075\u0026thinsp;\u0026plusmn;\u0026thinsp;4.034\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.200\u0026thinsp;\u0026plusmn;\u0026thinsp;6.155\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003eNote: PD psychotic depression; SCZ schizophrenia; HAMD Hamilton Depression Scale-24items; PANSS Positive and Negative Syndrome Scale; RBANS Repeatable Battery for the Assessment of Neuropsychological Status; Values are expressed as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003e3.2 ReHo\u003c/h2\u003e \u003cp\u003eCompared with SCZ, the brain areas with significant differences in PD were the left precuneus (Peak coordinates of \u0026minus;\u0026thinsp;9, \u0026minus;\u0026thinsp;72, 39; t\u0026thinsp;=\u0026thinsp;5.634, voxel size\u0026thinsp;=\u0026thinsp;27, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05, GRF correction, two-tailed). (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003e3.3 Pearson correlation analysis\u003c/h2\u003e \u003cp\u003eThe ReHo values of the left precuneus were negatively correlated with visuospatial construction and delayed memory (List recognition) score (\u003cem\u003er\u003c/em\u003e\u003csub\u003evisuospatial construction\u003c/sub\u003e = -0.287, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.015; \u003cem\u003er\u003c/em\u003e\u003csub\u003edelayed memory (List Recognition)\u003c/sub\u003e = -0.256, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.031). (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eThe results of this study showed that SCZ patients had lower cognitive function than PD patients. Compared to PD patients, SCZ patients had higher ReHo values in the left precuneus. Furthermore, the left precuneus ReHo values were negatively correlated with visuospatial construction and delayed memory (list recognition) scores, indicating that SCZ patients performed worse than PD patients in terms of visuospatial construction and delayed memory.\u003c/p\u003e \u003cp\u003eIn both SCZ and PD, cognitive impairments are a common symptom \u003csup\u003e\u003cspan additionalcitationids=\"CR31 CR32\" citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e\u003c/sup\u003e. However, there are differences in cognitive impairments between these two disorders. Cognitive impairments in patients with SCZ typically manifest as more severe deficits in attention, working memory, executive function, and inhibitory control \u003csup\u003e\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e,\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e\u003c/sup\u003e. Additionally, individuals with SCZ may experience disturbances or disorders of consciousness, which can have a significant impact on cognitive functioning \u003csup\u003e\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e\u003c/sup\u003e. In contrast, the severity of cognitive impairments in patients with PD may be relatively mild \u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e. Additionally, patients may exhibit impairments in working memory, executive function, and inhibitory control. Individuals with PD typically maintain a clear level of consciousness and do not experience disturbances or disorders of consciousness \u003csup\u003e\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e,\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e\u003c/sup\u003e. Our study indicates that the cognitive test scores of individuals with SCZ were lower than those of individuals with PD, which is consistent with previous research and suggests that cognitive impairments in SC are more severe than in PD. The study demonstrates that cognitive function can be significantly improved in PD patients as depressive symptoms subside \u003csup\u003e\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e\u003c/sup\u003e. However, cognitive impairment in SC is generally considered irreversible as it is believed to be related to neural damage \u003csup\u003e\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e,\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e\u003c/sup\u003e. Therefore, cognitive testing can be helpful in distinguishing between the diagnoses of these two diseases.\u003c/p\u003e \u003cp\u003eOur study demonstrated that compared to PD, SCZ had higher ReHo values in the left precuneus. The precuneus, located in the posterior superior region of the cerebral hemisphere, is a major functional area of the brain involved in various cognitive functions such as spatial perception, visual-spatial processing, memory, emotion, and consciousness \u003csup\u003e\u003cspan additionalcitationids=\"CR43\" citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e\u003c/sup\u003e. In neuroscience research, the functional activity of the precuneus is frequently measured and explored, and it is also often of interest in studies of psychiatric disorders \u003csup\u003e\u003cspan additionalcitationids=\"CR46 CR47\" citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e\u003c/sup\u003e. The activation of the precuneus is associated with the vividness of judgments during episodic memory retrieval \u003csup\u003e\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e\u003c/sup\u003e. Research has demonstrated that individuals with schizophrenia who experience auditory verbal hallucinations exhibit increased spontaneous neural activity in the left precuneus region compared to healthy controls, resulting in elevated ReHo values \u003csup\u003e\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e\u003c/sup\u003e. Our research findings also support this conclusion, as we have found that the more severe the cognitive impairment, the more prominent the neural activity in the left precuneus. The left precuneus is a central brain region of the default mode network (DMN) and an important hub of the resting-state brain connectivity network that underlies human cognitive functions. Therefore, changes in the functional connectivity of the left precuneus may serve as an indicator to differentiate between cognitive impairments in patients with SCZ and those with PD.\u003c/p\u003e \u003cp\u003eWe conducted a correlation analysis between the cognitive scores in RBANS and the ReHo values of the left precuneus. The results showed a significant negative correlation between the scores of visuospatial construction and delayed memory and the abnormal activity in this brain region. Research has found that patients with SCZ exhibit abnormal behavioral patterns and inflexible eye movement strategies in visuospatial problem-solving tasks \u003csup\u003e\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e\u003c/sup\u003e. And other researches had shown that patients with SCZ exhibit significant declines in visual spatial ability \u003csup\u003e\u003cspan additionalcitationids=\"CR53\" citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e\u003c/sup\u003e, as well as significant deterioration in delayed memory \u003csup\u003e\u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e55\u003c/span\u003e,\u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e\u003c/sup\u003e. This leads to a poorer prognosis for SCZ \u003csup\u003e\u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e\u003c/sup\u003e and may be one of the factors contributing to the worse prognosis of SCZ compared to PD. As is well known, the precuneus is one of the main integration centers of functional and structural processes in the human brain, playing an important role in visual-spatial integration, memory, and self-awareness. At the same time, it also links visual information with other brain processing systems involved in executive functions. Research has shown that when patients have focal brain damage in the precuneus, their cognitive function can be impaired to varying degrees \u003csup\u003e\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e,\u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e58\u003c/span\u003e\u003c/sup\u003e, which further supports our point.\u003c/p\u003e \u003cp\u003eIn summary, cognitive function tests can serve as an important indicator of differences between PD and SCZ in clinical practice. Abnormal activity in the left precuneus may be a core brain region that distinguishes PD from SCZ and is closely related to cognitive impairment. This provides neuroimaging evidence for clinical differential diagnosis and sheds light on the pathological mechanisms underlying cognitive impairment.\u003c/p\u003e \u003cp\u003eThere are some limitations in this study. Firstly, in order to minimize the possibility of diagnostic errors, we only selected PD and SCZ patients with a disease duration of more than 2 years and excluded SCZ patients who could not cooperate, which may result in selection bias. Secondly, this study used a cross-sectional observational design, which cannot determine causality of the observed differences and requires longer-term longitudinal studies. Finally, due to the small sample size of available studies, further research is needed to explore the clinical and functional relevance of cluster members. Therefore, future studies should use more rigorous designs and large sample sizes to validate our results and explore the pathological mechanisms of cognitive differences in PD and SCZ patients.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of Interest\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have no potential or actual conflicts of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was supported by the project of Foshan Science and Technology Bureau (2220001004473, 2220001004879) and the Foshan \u0026quot;14th five-year plan\u0026quot; medical high level key psychiatric specialty construction project (FSGSP145069).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability Statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated and/or analyzed during the current study are not publicly available due to confidentiality but are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contribution\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWensheng Chen, Xiaoling Li, Chunguo Zhang, and Jiaquan Liang have made great contributions to the conception, design and writing of the works; Other authors have provided assistances in the acquisition, analysis, or interpretation of data.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eOwen, M. 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Brain Struct Funct 227, 3099\u0026ndash;3108, doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1007/s00429-022-02556-0\u003c/span\u003e\u003cspan address=\"10.1007/s00429-022-02556-0\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e (2022).\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Psychotic depression, Schizophrenia, ReHo, Rs-fMRI, Cognition","lastPublishedDoi":"10.21203/rs.3.rs-2856800/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-2856800/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e Psychotic depression (PD) and schizophrenia (SCZ) are disorders with shared symptoms but unique causes, development, and treatments. Identifying them based on symptoms is difficult, requiring deeper comprehension of cognitive and neural mechanisms for accurate diagnosis and treatment.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAim:\u003c/strong\u003e This study aims to compare cognitive impairments and brain functional activities in PD and SCZ, in order to identify unique features of each disorder.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eWe studied 42 PD and 30 SCZ patients using RBANS and rs-fMRI. We computed ReHo values from the rs-fMRI data and compared RBANS scores between groups. We also investigated the correlation between cognition and brain function using Pearson analysis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003e(1) SC group had lower RBANS scores than PD group in all test sections; (2) Left precuneus had significant ReHo difference between PD and SC groups, with SCZ group showing significantly increased ReHo (p \u0026lt; 0.05); (3) Negative correlation found between visuospatial construction score, delayed memory score and ReHo value of left precuneus by Pearson correlation analysis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003econclusion: \u003c/strong\u003eCognitive impairment is more severe in SCZ than PD. Elevated left precuneus activity distinguishes PD from SCZ and relates to cognitive deficits in both, offering neuroimaging evidence for differential diagnosis and insight into cognitive impairment pathology.\u003c/p\u003e","manuscriptTitle":"Differences of regional homogeneity and cognitive function between psychotic depression and drug-naïve schizophrenia","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2023-05-02 18:41:37","doi":"10.21203/rs.3.rs-2856800/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"699a187a-afe4-43b7-b60e-c6776349237f","owner":[],"postedDate":"May 2nd, 2023","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":21058416,"name":"Biological sciences/Neuroscience/Cognitive neuroscience"},{"id":21058417,"name":"Biological sciences/Neuroscience/Emotion"},{"id":21058418,"name":"Biological sciences/Neuroscience/Neurogenesis"},{"id":21058419,"name":"Health sciences/Neurology/Neurological disorders"}],"tags":[],"updatedAt":"2023-09-13T19:59:18+00:00","versionOfRecord":[],"versionCreatedAt":"2023-05-02 18:41:37","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-2856800","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-2856800","identity":"rs-2856800","version":["v1"]},"buildId":"_2-kVJe1T_tPrBINL-cwx","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}