الفهرس 
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Abstract
Schizophrenia, a debilitating psychotic disorder, affects approximately 1% of the population and is characterized by disordered thought processes as well as impaired emotional responses it was ranked among the top 15 leading causes ofdisability worldwide in 2016.
Schizophrenia is known to be associated with cognitive impairment the most important domains of cognitive deficit in schizophrenia are working memory, attention/vigilance, verbal learning and memory, visual learning and memory, reasoning and problem solving, speed of processing, and social cognition
Social cognition, with its 4 domains emotion processing, social perception, theory of mind and attibutional style, has attracted wide interest over the last 10 years encouraged by recent evidence that it may be independent of neurocognition (attention, language, executive functions) and have a mediating role between the neurocognition and social behaviour exhibited by patients with schizophrenia, such defcits are critical predictors of functional outcomes because they affect the ability to create and maintain interpersonal relationships.
Schizophrenia has been widely described in terms of a dys-connection syndrome, which meant to reflect an aberrant integration of the brain networks.
The two networks considered to be involved in theory of mind and social cognition are the MNS and the mentalizing network-are of special interest in schizophrenia. Better understanding how these deficits arise is critical to developing effective strategies for remediating social cognition and function in schizophrenoia.
Nowadays it is widely established that WM abnormalities are prevalent in the disorder.
Diffusion tensor imagings (DTI) have been used to demonstrate WM abnormalities in schizophrenia. As a modified technique of magnetic resonance imaging (MRI), used to characterize the main WM fiber bundles in vivo.
DTI studies have reported microstructural abnormalities of WM in schizophrenia patients, characterized by lower FA throughout the brain in individuals with Schizophrenia
Our aim in this study is:
To use diffusion tensor imaging (DTI) to evaluate the white matter (WM) microstructure abnormalities of the premotor area, the inferior parietal lobule and the anterior cingulate gyrus in patients diagnosed with schizophrenia. We used these regions as approximation for MN hub locations, based on previous functional experiments.
To test for an association between measures of WM microstructure and measures of social cognition.
Secondary aim is to detect an association between measures of WM microstructure to negative versus positive symptoms in patients with schizophrenia.
Another secondary aim to correlate WM alteration & social cognition to executive functions.
To our knowledge this study is one of the earliest studies discussing the WM abnormalities in schizophrenia patients with correlation to their negative symptoms and social cognition. The present study involved 15 patients randomly recruited from the general psychiatric inpatient and outpatient clinic in the institute of psychiatry Ain Shams University.diagnosed with schizophrenia disorder based on interviews with the structured clinical interview for the DSM-IV-TR, Research version (SCID I) for ages <18. Our goal was to find wether there is a correlation between white matter abnormalties with severity of negative symptoms and social cognition affection.
All patients involved in the current study were subjected to:
Anhedonia and Asociality subscale of the scale for the assessment of negative symptoms (SANS)
Scale for the assessment of postive symptoms (SAPS)
Intelligence Quotient (IQ) using Wechsler Adult Intelligence Scale (WAIS) and patients with IQ 70 or more were included in the study.
Cognitive functions performed by trained psychologist except continuous performance test (CPT) that was applied by the researcher:
Executive functions using Wisconsin Card Sorting Test (WCST) and Trail Making Test part B.
Sustained attention using Continuous Performance Test.
Attention using Trail Making Test part A.
Memory using Wechsler memory scale revised III (WMS-R III).
White matter integrity as measured by fraction anisotropy of (premotor area, inferior parietal lobule and the anterior cingulate gyrus)
The main findings in our study:
In our study, we covered two important areas in schizophrenia patients in comparison to controls:
1- White matter abnormalities
2- Social cognition affection
Also in our study we covered two important correlations in schizophrenia patients:
1- Correlation of white matter abnormalities with cognitive functions.
2- Correlation between white matter abnormalities with negative vs positive symptoms.
3- Correlation of white matter abnormalities with measures of social cognition.
Comparison between patients group and control group:
Our control group was well match to schizophrenia group regarding socio demographic characteristics except for occupation as most of case group were unemployed.
There were statistically highly significant lower IQ scores in case group than control group.
As regard, cognitive functions we found statistically significant poor performance of case group than control group in all domains of cognitive tests we used in our study except for recall, Arithmetic’s, Similarities and Picture completion.
As regard DTI findings, we found statistically significantly lower trace in case group than control group in the following regions.
Anterior cingulate gyrus, right and left inferior parietal lobe, right and left premotor area
As regard Correlation of Anhedonia & Associability subscale of SANS, scale of negative symptoms (SANS) Total and scale of positive symptoms (SAPS) with DTI findings, we found:
Patients show significantly high score in Anhedonia & Associability subscale of SANS and SANA total in relation to low trace in right inferior parietal lobe as well as right and left premotor area.
Patients show a very highly significant correlation with the ability to feel intimacy and the right and left premotor area with no correlation in the relationship between friends and beers.
Patients also show significant correlation between SAPS and trace of right inferior parietal lobe only.
As regard Correlation of WM abnormalities with cognitive functions:
No correlation between anterior cingulate gyrus and cognitive functions.
Right inferior parietal lobe FA was positively correlated to comprehension.
Left premotor area Trace was positively correlated to omission error of continuous performance test and Trail making test part A.
Social impairment is a core feature of schizophrenia spectrum disorders, predicting functional disability. Moreover, social deficits are minimally responsive to standard schizophrenia treatments. Investigating mechanisms that underlie social dysfunction is critical to developing targeted interventions to prevent and treat schizophrenia.