# Large-scale mechanism hypothesis and research prospects of cognitive impairment in schizophrenia based on magnetic resonance imaging

## TL;DR

This paper explores how brain connectivity issues in schizophrenia may cause cognitive impairments and suggests potential treatments using MRI and brain stimulation.

## Contribution

Proposes a novel hypothesis linking DLPFC-IPL pathway damage to cognitive impairments in schizophrenia, supported by MRI findings.

## Key findings

- First-episode schizophrenia patients show connectome damage and abnormal DLPFC and IPL activation.
- DLPFC-IPL pathway destruction is suggested as a mediator of cognitive impairments in schizophrenia.
- Multimodal MRI and neuromodulation could validate the hypothesis and identify IPL as an intervention target.

## Abstract

Cognitive impairments in schizophrenia are pivotal clinical issues that need to be solved urgently. However, the mechanism remains unknown. It has been suggested that cognitive impairments in schizophrenia are associated with connectome damage, and are especially relevant to the disrupted hub nodes in the frontal and parietal lobes. Activating the dorsolateral prefrontal cortex (DLPFC) via repetitive transcranial magnetic stimulation (rTMS) could result in improved cognition. Based on several previous magnetic resonance imaging (MRI) studies on schizophrenia, we found that the first-episode patients showed connectome damage, as well as abnormal activation and connectivity of the DLPFC and inferior parietal lobule (IPL). Accordingly, we proposed that DLPFC-IPL pathway destruction might mediate connectome damage of cognitive impairments in schizophrenia. In the meantime, with the help of multimodal MRI and noninvasive neuromodulation tool, we may not only validate the hypothesis, but also find IPL as the potential intervention target for cognitive impairments in schizophrenia.