首发和慢性精神分裂症幻听患者的扩散张量成像研究

目的:探索首发和慢性精神分裂症幻听患者是否存在听觉、语言及记忆/边缘系统网络的相关白质纤维异常。方法:纳入21例首发和12例慢性精神分裂症幻听患者及人口学参量匹配的26例健康对照。收集所有研究对象的DTI数据,采用基于纤维束的空间统计分析方法比较两组患者和对照组间的白质纤维差异。结果:与对照组相比,首发精神分裂症幻听患者在胼胝体、上纵束、下额枕束、钩束、扣带束、外囊及内囊前肢区域部分各向异性(FA)显著降低,径向扩散张量(RD)显著升高。慢性精神分裂症幻听患者表现出比首发患者更广泛的白质损害,且除FA和RD的改变外,部分脑区还表现出轴向扩散张量(AD)的升高。结论:精神分裂症幻听患者存在连接语言、听觉和记忆/边缘系统网络的多种白质纤维异常。慢性精神分裂症幻听患者与首发患者相比可能表现出更严重的神经退行性改变。

A diffusion tensor imaging study on first episode and chronic schizophrenic patients with auditory hallucination

Objective: To explore whether auditory hallucination(AH) in schizophrenia are associated with the white matter abnormalities in tracts associated with language, auditory and memory/limbic networks in first episode and chronic schizophrenia patients. Methods: Twenty-one first-episode(FE-AH) and 12 chronic(Chronic-AH) patients who suffered from AH and 26 match healthy controls(HC group) were enrolled. Diffusion tensor imaging with tract-based spatial statistics was performed to assess the white matter changes between the patient group and the HC group. Results: Decreased fractional anisotropy and increased radial diffusivity were found in the patient groups compared with the HC group in multiple white matter tracts including the corpus callosum, superior longitudinal fasciculus, inferior fronto-occipital fasciculus, uncinate fasciculus, cingulum, external capsule and anterior limb of the internal capsule. The Chronic-AH group showed more widespread white matter impairment than the FE-AH group. Furthermore, increased axial diffusivity was also observed in some discrete regions in the Chronic-AH group. Conclusion: Auditory hallucination in schizophrenia is accompanied with white matter abnormalities in tracts associated with the language, auditory and memory/limbic networks. Chronic-AH schizophrenia patients may present more severe neurodegeneration than those first-episode patients.