首发精神分裂症患者的脑灰质减少

目的 采用基于体素的形态学(VBM)分析方法对高分辨磁共振图像进行分析,研究首发精神分裂症患者大脑灰质变化,探讨患者脑灰质改变与临床症状之间的关系.方法 对符合CCMD-3诊断标准的首发精神分裂症患者以及健康志愿者各16例进行脑结构核磁共振扫描,并应用VBM进行脑灰质体积分析.所有患者均完成阳性与阴性症状量表(PANSS)评估.结果 与健康对照相比,患者组灰质密度降低的脑区有右侧小脑(t=5.17,P＜0.001)、右侧顶上回(t=5.01,P＜0.001)、左侧颞上回至岛叶被盖(t=4.79,P＜0.001)、左侧额中回(t=4.71,P＜ 0.001)、左侧额下回(t=4.70,P＜0.001)、右侧舌回(t=4.62,P＜ 0.001)、左侧海马杏仁体(t=4.11,P＜0.001).患者组左侧Heschl's回的灰质密度与PANSS量表总分(r=-0.509,P=0.044)以及PANSS阳性症状量表得分(r=-0.554,P=0.026)呈显著负相关.结论 首发精神分裂症患者的脑灰质减少以左侧额、颞叶为主,其中左侧Heschl's回灰质变化与患者的精神病性症状有相关性.

A VBM study of the grey matter changes in first - episode schizophrenia

Objective To investigate the gray matter changes in first-episode schizophrenic（FES） patients using VBM （Voxel Based Morphometry）method to analyze magnetic resonance images, and to explore the relationship between the gray matter changes in patients and their clinical symptoms. Methods 16 FES outpatients who met CCMD- 3 diagnostic criteria for schizophrenia and 16 healthy controls underwent high-resolution T1 weighted imaging. Images were processed using voxel-based morphometry method and the clinical Symptoms were assessed using the Positive and Negative Syndrome Scale（PANSS）. Results FES patients presented significantly reduced GM volume in the right cerebellum （t = 5.17, P = 0. 001）, right superior parietal gyrus （t = 5.01, P 〈 0. 001）, left superior temporal gyrus extending to Rolandic operculum cortex （t ： 4.79, P 〈 0. 001）, left middle frontal gyrus （t = 4.71, P 0. 001）, left inferior frontal gyrus （t = 4.70 ,P 〈 0.001）, the right lingual gyrus （t ： 4.62 ,P 〈 0. 001） as well as left hippocampus/amygdala （t = 4.11, P 〈 0.001 ）, compared with the healthy controls. In addition,the GM volume of left Heschl＇s gyrus in FES patients were negatively correlated with positive scale scores （r ：- 0.554,P = 0.026） and PANSS total score （r =- 0.509,P = 0.044）. Conclusions Several brain areas mainly in left frontal lobe and left temporal lobe were statistically decreased in FES patients,and there were significant correlations between left Heschl＇s gyrus volume and clinical symptoms.