Alterations in regional homogeneity in schizophrenia patients comorbid with metabolic syndrome treated with risperidone or clozapine

The neuroimaging mechanisms that arise in patients with schizophrenia and comorbid metabolic syndrome (MetS) remain poorly understood. This study was devised to examine potential alterations in regional homogeneity (ReHo) that arise in schizophrenia patients with comorbid MetS undergoing risperidone or clozapine treatment. In total, 43 schizophrenia patients undergoing risperidone or clozapine treatment were enrolled in this study, of whom 20 had comorbid MetS (SZ-MetS) while 23 did not (SZ-nMetS). In addition, 28 sex- and age-matched healthy controls (HCs) were analyzed. Analyses of covariance (ANCOVA) were used to compare ReHo in this study, utilizing age, sex, and years of education as covariates, with subsequent post hoc testing. Correlations between brain regions showing differences between groups of patients with schizophrenia and MetS-related indicators were also assessed. Relative to HCs, patients in both the SZ-MetS and SZ-nMetS groups exhibited reductions in ReHo in the right postcentral gyrus, left superior parietal gyrus, and left middle occipital gyrus. A decrease in ReHo was also evident in the left calcarine fissure and surrounding cortex and the right angular gyrus of patients in the SZ-MetS group, while the SZ-nMetS group exhibited reductions in ReHo in the left superior occipital gyrus and the right precuneus, together with an increase in ReHo in the right inferior orbitofrontal gyrus. Compared to the SZ-nMetS group, the SZ-MetS group exhibited a reduction in ReHo in the right inferior orbitofrontal gyrus. The ReHo of the right inferior orbitofrontal gyrus was significantly negatively correlated with BMI, waist circumference, and hip circumference in the SZ-MetS and SZ-nMetS groups. A reduction in ReHo in the right inferior orbitofrontal gyrus may thus be related to MetS in schizophrenia patients undergoing treatment. The findings may provide an imaging basis for brain alterations in patients with schizophrenia combined with MetS and provide a new insight into the neuroimaging mechanisms associated with MetS in patients with schizophrenia.