首发精神分裂症精神病未治期对认知功能和社会功能的影响

目的探讨首发精神分裂症精神病未治期(duration of untreated psychosis,DUP)对认知功能和社会功能的影响。方法纳入首发且DUP≤2年的精神分裂症患者93例和正常对照93名。采用阳性和阴性症状量表(positive and negative symptoms scale,PANSS)评定患者的临床病理症状,Matrics公认认知成套测验(Matrics consensus cognitive battery,MCCB)评定所有被试认知功能,个人和社会功能量表(personal and social performance scale,PSP)和功能大体评定量表(global assessment function scale,GAF)评定所有被试社会功能。结果精神分裂症组在连线测验、符号编码、范围流畅性测验、Stroop色词测验、持续操作测验、空间广度、霍普金斯言语记忆测验-修订版(Hopkins verbal learning test-revised,HVLT-R)、简易视觉空间记忆测验(brief-visuospatial memory test-revised,BVMT-R)和迷宫测验方面的得分均低于对照组,且差异有统计学意义(均P0.05)。精神分裂症组的GAF得分和PSP得分均低于对照组,差异具有统计学意义(均P0.05)。精神分裂症患者DUP与HVLT-R2(r=-0.265,P=0.010)和BVMT-R3(r=-0.328,P=0.001)分别呈负相关,DUP与GAF(r=-0.292,P=0.005)和PSP(r=-0.397,P0.001)得分分别呈负相关。结论首发精神分裂症患者存在社会功能和广泛的认知功能损害,且DUP越长,患者的认知功能和社会功能越差。     

精神分裂症超高危人群及首次发病患者的认知功能研究

目的:探讨精神分裂症超高危人群及首次发病患者认知功能损害特点。方法:运用精神分裂症认知功能成套测验-共识版(MCCB)和Stroop色词测验对精神分裂症超高危者(超危组)、首次发病患者(首发组)及正常对照者(正常组)进行认知功能评定,每组各20例。结果:3组间连线测试和霍普金斯词语学习测验修订版(HVLT-R)成绩差异无统计学意义;符号编码、简易视觉记忆测验-修订版(BVMT-R)、持续操作测验(CPT)成绩各组间差异有统计学意义(P均0.05);超危组成绩介于首发组与正常组。结论:精神分裂症患者发病前已出现认知功能损害,并可能随疾病发作进一步加重。     

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.     

加兰他敏改善精神分裂症患者认知功能的研究

目的 探讨加兰他敏是否能改善精神分裂症患者的认知功能.方法 80例精神分裂症患者被随机分为利培酮单药治疗组(单药组,入组40例,完成30例)和利培酮合并加兰他敏治疗组(合并组,入组40例,完成34例),疗程8周.治疗前后采用阳性和阴性综合征量表(PANSS)评定精神症状,个人和社会功能量表(PSP)评定社会功能,视觉空间记忆测验(BVMT-R)、霍普金斯词语学习测验修订版(HVLT-R)、WAIS-Ⅲ数字符号以及连线测试评定患者的认知功能.结果 治疗后,两组患者的PANSS评分显著下降,PSP量表的总分显著上升,单药组阳性症状改善更明显(P＜0.05),两组患者社会功能改善无显著性差异(P＞0.05).治疗后,两组患者在BVMT-R测验中均有显著改善(P＜0.01),单药组在HVLT-R测验中有显著改善(P＜0.05),合并组在WAIS-Ⅲ数字符号测试中有显著改善(P＜0.01),两组患者间各项认知功能项目评定结果比较均无显著性差异(P＞0.05).结论 加兰他敏并不能有效改善精神分裂症患者的认知功能.     

精神分裂症首次发病患者及其健康同胞认知功能的比较研究

目的 比较精神分裂症首次发病患者与健康同胞及正常对照认知功能的差异,探讨精神分裂症在认知功能领域的内表型.方法 采用目前常用的范畴流畅测验(CFT)、数字符号编码测验(DSCT)、连线测验(TMT)、韦克斯勒记忆量表第3版(WMS-Ⅲ)空间广度测验(WMS-ⅢSST)、霍普金斯词汇学习测验-修订版(HVLT-R)、简易视觉空间记忆测验-修订版(BVMT-R)、定步调听觉连续加法测验(PASAT)和威斯康星卡片分类测验-64(WCST-64)对92例精神分裂症首次发病患者(患者组)、56例健康同胞(同胞组)和62名健康对照者(对照组)的认知功能进行检测.结果 (1)患者组所有神经心理测验成绩均差于对照组,差异有统计学意义(P＜0.01).(2)同胞组的CFT、DSCT、TMT、HVLT-R即刻记忆和延迟记忆、BVMT-R即刻记忆、PASAT、WCST-64持续错误数、持续反应数和完成分类数的测验成绩差于对照组,差异有统计学意义(P＜0.05).(3)患者组与同胞组的CFT、WCST-64中的持续错误数、持续反应数和完成分类数测验成绩分别为(18.40±12.12)分比( 18.86±5.19)分、(16.48±8.19)分比(14.80±5.86)分、(18.76±10.91)分比(16.86 ±7.73)分、(1.33±2.81)分比(1.63±1.36)分,2组比较差异无统计学意义(P＞0.05),其他神经心理测验成绩比较,患者组差于同胞组,差异有统计学意义(P＜0.05).结论 精神分裂症首次发病患者存在处理速度、工作记忆、言语记忆、空间记忆、注意警觉和执行功能广泛性的认知功能损害,精神分裂症健康同胞存在处理速度、言语记忆、视觉记忆、注意警觉、执行功能的认知缺陷;语义流畅性功能和执行功能可能是精神分裂症的潜在内表型.     

精神分裂症首次发病患者治疗早期神经认知功能改变的对照研究

目的 探讨精神分裂症首次发病患者治疗早期神经认知功能受损的程度和范围.方法 采用成套神经心理测验工具,包括连线测验A、颜色连线测验、《韦克斯勒记忆量表(第3版)》空间广度测验、《韦克斯勒量表(第3版)》(WAIS-Ⅲ)符号搜索和数字符号、霍普金斯词汇学习测验-修订版(HVLT-R)、简易视觉空间记忆测验-修订版(BVMT-R)、沟槽钉板测验和定步调听觉连续加法测验(PASAT)测试77例16 ～ 28岁的精神分裂症首次发病患者(病例组)和80名健康者(对照组)的学习和记忆、精细动作、信息处理速度以及执行功能,采用SPSS16.0统计软件包对所有数据进行统计学分析.结果 共有21项评价指标的效应值＞0.80(P ＜0.001),整体受损效应值在0.47 ～3.41个标准差;病例组沟槽钉板测验完成时问[利手(84.77±31.55)s,非利手(97.95 ±42.30)s]均显著长于对照组[(59.00±7.57)s,ES =3.41,F=43.28;(66.84±10.74)s,ES =2.90,F=35.75;P均＜0.001],连线测验A[(50.88 ±27.45)s]、颜色连线1完成时间[(54.59±25.62)s]和颜色连线2完成时间[(117.38±52.66)s]显著长于对照组[(27.25±8.49)s,ES=2.78,F=42.66;(29.64±9.49)s,ES =2.63,F=58.82;(66.34±15.06)s,ES =3.39,F=60.51;P＜0.001],PASAT尝试数[(36.43±9.88)个]和正确数[(31.11±11.09)个]显著低于对照组[(46.85±3.42)个,ES=-3.04,F=72.52;(44.15 ±5.08)个,ES=-2.57,F=81.10;P均＜0.001],WAIS-Ⅲ数字符号得分[(59.81 ±15.11)分]显著低于对照组[(91.13±10.87)分,ES=-2.88,F=179.33,P＜0.001],病例组BVMT-R测试各项得分显著低于对照组(P＜0.050).结论 精神分裂症首次发病患者神经认知功能全面受损.     

首发精神分裂症患者的认知功能与脑灰质体积的相关研究（英文）

背景:认知功能损害是精神分裂症的核心症状之一,其恢复程度关系到患者能否重新回归社会。目的:明确精神分裂症认知功能与脑灰质体积的关系。方法:采用画钟测试、连线测试、数字广度测试、听觉词语测试、威斯康星卡片分类测验、言语流畅性测试、语义相似性测验、斯特鲁色词测试对37例首发精神分裂症住院患者(病例组)和30名健康对照组(对照组)进行神经认知功能检测,采用面孔情绪认知任务测试对32例首发精神分裂症住院患者(病例组)和29名健康对照组(对照组)进行面孔情绪认知功能检测,采用阳性和阴性症状量表(Positive and Negative Syndrome Scale,PANSS)评定首发精神分裂症住院患者的精神症状,利用磁共振分别对病例组和对照组进行脑部影像学数据的采集。结果:病例组和对照组在画钟测试、连线测试、数字广度测验、听觉词语测验、威斯康星卡片分类测验、言语流畅性测验、语义相似性测验、斯特鲁色词测验反应时间中,两组间的差异有统计学意义;面孔情绪认知任务测试斜率(Slope)之间有统计学意义;病例组与对照组的脑灰质体积差异比较发现病例组的左侧额上回的灰质体积增加,左侧枕下回、舌回和小脑上部灰质体积减少;病例组神经认知数据与脑影像学数据分析,斯特鲁色词测验中的卡片C正确反应个数测验分数,显示与左侧额上回和右侧额上回、额中回灰质体积负相关;病例组面孔情绪认知任务与脑影像学数据分析,病例组转换斜率数据的相关灰质异常脑区为与右侧颞上回、颞中回,左侧颞中回、颞下回和梭状回灰质体积成正相关。结论:首发精神分裂症住院患者的神经认知功能和面孔情绪认知功能存在广泛性损害,上述结果提示灰质体积异常脑区可能为认知功能障碍的脑结构和功能基础。     

精神分裂症患者认知功能、听觉事件诱发电位P300和脑灰质体积的相关分析

目的 分析经抗精神病药治疗后病情基本稳定但仍残留部分症状的非急性期精神分裂症患者认知功能、听觉事件诱发电位P300和脑灰质体积的相关性.方法 采用听觉事件诱发电位P300、神经心理认知测验对18例非急性期精神分裂症患者(患者组)和18名健康对照者(对照组)进行认知功能检测;采用PANSS和临床总体印象量表(Clinical Global Impression Scale-Severity,CGI-S)评定患者的精神症状,锥体外系副反应量表(Extrapyramidal Side Effects Scale,SAS)、不自主运动量表(Abnormal Involuntary Movement Scale,AIMS)和静坐不能量表(Barnes Akathisia Rating Scale,BARS)评定既往使用抗精神病药的不良反应情况.利用磁共振和脑诱发电位仪分别对患者和对照者进行脑部影像学、神经电生理检查.结果 神经心理认知功能测验中持续性操作测验(Continuous Performance Test,CPT)两位数和三位数测验患者组(2.5±1.2、2.1±1.2)较对照组(3.5±0.6、2.9±0.8)评分低(t=-3.088、-2.563,均P＜0.05);Stroop色词干扰测试的单词、颜色和色词测试总分患者组(77.1 ±16.6、32.4±7.3和32.4±7.3)均较对照组(89.3±8.9、41.8±6.8、41.8±6.8)评分低(t=-2.733、-4.015、-4.015,均P＜0.05);沟槽钉板测验利手和非利手患者组(69.9±10.9、77.3±11.4)较对照组(56.7±7.1、68.7±10.8)完成测试时间延长(t=-4.015、2.313,均P＜0.05);颜色连线2患者组(46.3±18.1)较对照组(37.4±10.6)测试完成时间长(=4.638,P＜0.05);范畴流利测验患者组(11.8±5.1)较对照组(15.6±3.5)评分低(t=-2.593,P＜0.05),2组间比较差异有统计学意义.患者组的P300潜伏期N2(237.1±19.6)与对照组(217.6±26.6)比较延长(=2.966,P＜0.05),波幅差异无统计学意义.P300波幅与迷宫测试、颜色连线及威斯康星卡片分类测验(Wisconsin Card Sorting Test,WCST)正确数呈正相关(r=0.493、0.527、0.512,均P＜0.05),与沟槽钉板、WCST错误数呈负相关(r=-0.571、-0.512,均P＜0.05).患者组的内侧前额叶、右侧颞叶和小脑部分区域的灰质体积较对照组下降,差异有统计学意义,P300潜伏期与局部脑灰质体积(右颞叶的颞上回和颞中回、右后叶小脑扁桃体、右侧小脑后叶、下半小叶)呈负相关(均P＜0.01).结论 非急性期精神分裂症患者的认知功能存在广泛损害.患者内侧前额叶、颞叶、小脑灰质体积异常,且右侧颞叶、右侧小脑局部灰质体积与P300潜伏期相关,提示颞叶、小脑等区域可能是P300异常的脑结构和功能基础.     

比较3种非典型抗精神病药对精神分裂症首次发作患者处理速度测验的影响

目的比较奥氮平、利培酮和阿立哌唑三种非典型抗精神病药对精神分裂症首次发作患者处理速度测验成绩的影响。方法 91例精神分裂症首发患者随机分配至阿立哌唑组(n=27)、利培酮组(n=37)和奥氮平组(n=27),在治疗前和治疗12周末完成如下测验:阳性与阴性症状量表、沟槽钉板测验、连线测验、Stroop色词测验、数字符号编码测验和范畴流利测验。结果 (1)治疗12周后,三组PANSS评分均较治疗前显著降低(P0.001),三组间PANSS减分率的差异无统计学显著性;(2)奥氮平组治疗后的利手、连线A、颜色连线1、颜色连线2以及Stroop测验B得分均较治疗前显著改善(P0.05～0.001);利培酮组治疗后的连线A、颜色连线1、颜色连线2、Stroop测验C以及数字符号编码得分均较治疗前显著改善(P0.05～0.001);阿立哌唑组除颜色连线2外,其它各项评分的治疗前后比较差异无显著性(P0.05)。结论在对首发精神分裂症患者的处理速度的改善方面,奥氮平和利培酮可能优于阿立哌唑。     

精神分裂症首次发病患者大脑灰质结构的异常改变及其与幻听的相关性

目的:探讨首发精神分裂症患者的大脑灰质结构改变及与幻听的关系。方法:采用病例-对照研究方法,通过基于体素形态学分析法(VBM)对29例首发精神分裂症患者(患者组)和31名性别、年龄、受教育程度相匹配的正常对照者(正常对照组)进行头颅磁共振成像扫描,以SPM 8软件包为基础的全自动VBM分析大脑灰质结构;采用阳性与阴性症状量表和Hoffman幻听症状量表对患者进行评估;分析大脑灰质结构改变与患者的精神症状及幻听症状相关性。结果:与正常对照组相比,患者组左侧额中回(t=-3.89)、右侧楔叶(t=-4.05)及右侧梭状回(t=-3.88)灰质体积明显减少(P均0.001);其中左侧额中回的灰质体积与幻听的严重程度呈负相关(r=-0.42,P0.05)。结论:精神分裂症首次发病患者存在大脑左侧额中回灰质结构异常,可能是幻听形成的神经生物学基础。     

精神分裂症首次发病患者额顶网络功能连接与面孔情绪识别能力的关系

目的:探讨首发精神分裂症患者在静息状态下额顶网络的功能连接特点,及其与面孔情绪识别能力的相关性。方法:对37例首发未用药的精神分裂症患者(患者组)和30名年龄、性别、利手、受教育程度与患者相匹配的健康者(正常对照组)进行静息态功能磁共振(f MRI)扫描,收集两组的一般临床特征,并采用面孔情绪测试评价被试的面孔情绪认知功能;以双侧背外侧前额叶(DLPFC)为种子点比较两组间额顶网络功能连接的差异,并分析与面孔情绪认知功能的相关性。结果:与正常对照组相比,患者组DLPFC与左顶下小叶(t=-3.243,Alphasim校正P0.05)、左额下回(t=-3.151,Alphasim校正P0.05)、左额中回(t=-3.151,Alphasim校正P0.05)、双侧尾状核(t=-4.325,Alphasim校正P0.05)、左颞中回(t=-3.120,Alphasim校正P0.05)的功能连接减低;与双侧扣带回中部(t=2.731,Alphasim校正P0.05)、右中央前回(t=3.991,Alphasim校正P0.05)、右岛叶(t=3.991,Alphasim校正P0.05)功能连接增强。患者组额-顶通路的功能连接与面孔情绪认知障碍呈正相关(r=0.501,P0.05)。结论:首发精神分裂症患者额顶网络的功能连接存在异常,其中DLPFC-顶下小叶通路的功能连接降低可能影响患者面孔情绪识别能力。     

Progressive decrease of left superior temporal gyrus gray matter volume in patients with first-episode schizophrenia

OBJECTIVE: Smaller temporal lobe cortical gray matter volumes, including the left superior temporal gyrus, have been reported in magnetic resonance imaging (MRI) studies of patients with chronic schizophrenia and, more recently, in patients with first-episode schizophrenia. However, it remains unknown whether there are progressive decreases in temporal lobe cortical gray matter volumes in patients with first-episode schizophrenia and whether similarly progressive volume decreases are present in patients with affective psychosis. METHOD: High-spatial-resolution MRI scans at initial hospitalization and 1.5 years later were obtained from 13 patients with first-episode schizophrenia, 15 patients with first-episode affective psychosis (mainly manic), and 14 healthy comparison subjects. MRI volumes were calculated for gray matter of superior temporal gyrus and for the amygdala-hippocampal complex. RESULTS: Patients with first-episode schizophrenia showed significant decreases in gray matter volume over time in the left superior temporal gyrus compared with patients with first-episode affective psychosis or healthy comparison subjects. This progressive decrease was more pronounced in the posterior portion of the left superior temporal gyrus (mean=9.6%) than in the anterior portions (mean=8.4%). No group differences in the rate of change over time were present in other regions. CONCLUSIONS: These findings demonstrate a progressive volume reduction of the left posterior superior temporal gyrus gray matter in patients with first-episode schizophrenia but not in patients with first-episode affective psychosis.     

Association between smaller left posterior superior temporal gyrus volume on magnetic resonance imaging and smaller left temporal P300 amplitude in first-episode schizophrenia

BACKGROUND: In chronic schizophrenia, the P300 is broadly reduced and shows a localized left temporal deficit specifically associated with reduced gray matter volume of the left posterior superior temporal gyrus (STG). In first-episode patients, a similar left temporal P300 deficit is present in schizophrenia, but not in affective psychosis. The present study investigated whether the left temporal P300-left posterior STG volume association is selectively present in first-episode schizophrenia. METHOD: P300 was recorded as first-episode subjects with schizophrenia (n = 15) or affective psychosis (n = 18) or control subjects (n = 18) silently counted infrequent target tones amid standard tones. High-resolution spoiled gradient-recalled acquisition magnetic resonance images provided quantitative measures of temporal lobe gray matter regions of interest. RESULTS: Patients with first-episode schizophrenia displayed a reversed P300 temporal area asymmetry (smaller on the left), while magnetic resonance imaging showed smaller gray matter volumes of left posterior STG relative to control subjects and patients with affective psychosis (15.4% and 11.0%, respectively), smaller gray matter volumes of left planum temporale (21.0% relative to both), and a smaller total Heschl's gyrus volume (14.6% and 21.1%, respectively). Left posterior STG and the left planum temporale, but not other regions of interest, were specifically and positively correlated (r>0.5) with left temporal P300 voltage in patients with schizophrenia but not in patients with affective psychosis or in control subjects. CONCLUSION: These results suggest that the left temporal P300 abnormality specifically associated with left posterior STG gray matter volume reduction is present at the first hospitalization for schizophrenia but is not present at the first hospitalization for affective psychosis.     

Middle and inferior temporal gyrus gray matter volume abnormalities in first-episode schizophrenia: an MRI study

OBJECTIVE: Magnetic resonance imaging (MRI) studies of schizophrenia reveal temporal lobe structural brain abnormalities in the superior temporal gyrus and the amygdala-hippocampal complex. However, the middle and inferior temporal gyri have received little investigation, especially in first-episode schizophrenia. METHOD: High-spatial-resolution MRI was used to measure gray matter volume in the inferior, middle, and superior temporal gyri in 20 patients with first-episode schizophrenia, 20 patients with first-episode affective psychosis, and 23 healthy comparison subjects. RESULTS: Gray matter volume in the middle temporal gyrus was smaller bilaterally in patients with first-episode schizophrenia than in comparison subjects and in patients with first-episode affective psychosis. Posterior gray matter volume in the inferior temporal gyrus was smaller bilaterally in both patient groups than in comparison subjects. Among the superior, middle, and inferior temporal gyri, the left posterior superior temporal gyrus gray matter in the schizophrenia group had the smallest volume, the greatest percentage difference, and the largest effect size in comparisons with healthy comparison subjects and with affective psychosis patients. CONCLUSIONS: Smaller gray matter volumes in the left and right middle temporal gyri and left posterior superior temporal gyrus were present in schizophrenia but not in affective psychosis at first hospitalization. In contrast, smaller bilateral posterior inferior temporal gyrus gray matter volume is present in both schizophrenia and affective psychosis at first hospitalization. These findings suggest that smaller gray matter volumes in the dorsal temporal lobe (superior and middle temporal gyri) may be specific to schizophrenia, whereas smaller posterior inferior temporal gyrus gray matter volumes may be related to pathology common to both schizophrenia and affective psychosis.     

Fusiform gyrus volume reduction in first-episode schizophrenia: a magnetic resonance imaging study

BACKGROUND: The fusiform gyrus (occipitotemporal gyrus) is thought to be critical for face recognition and may possibly be associated with impaired facial recognition and interpretation of facial expression in schizophrenia. of postmortem studies have suggested that fusiform gyrus volume is reduced in schizophrenia, but there have been no in vivo structural studies of the fusiform gyrus in schizophrenia using magnetic resonance imaging. METHODS: High-spatial resolution magnetic resonance images were used to measure the gray matter volume of the fusiform gyrus in 22 patients with first-episode schizophrenia (first hospitalization), 20 with first-episode affective psychosis (mainly manic), and 24 control subjects. RESULTS: Patients with first-episode schizophrenia had overall smaller relative volumes (absolute volume/intracranial contents) of fusiform gyrus gray matter compared with controls (9%) and patients with affective psychosis (7%). For the left fusiform gyrus, patients with schizophrenia showed an 11% reduction compared with controls and patients with affective psychosis. Right fusiform gyrus volume differed in patients with schizophrenia only compared with controls (8%). CONCLUSION: Schizophrenia is associated with a bilateral reduction in fusiform gyrus gray matter volume that is evident at the time of first hospitalization and is different from the presentation of affective psychosis.     

Progressive decrease of left Heschl gyrus and planum temporale gray matter volume in first-episode schizophrenia: a longitudinal magnetic resonance imaging study

BACKGROUND: The Heschl gyrus and planum temporale have crucial roles in auditory perception and language processing. Our previous investigation using magnetic resonance imaging (MRI) indicated smaller gray matter volumes bilaterally in the Heschl gyrus and in left planum temporale in patients with first-episode schizophrenia but not in patients with first-episode affective psychosis. We sought to determine whether there are progressive decreases in anatomically defined MRI gray matter volumes of the Heschl gyrus and planum temporale in patients with first-episode schizophrenia and also in patients with first-episode affective psychosis. METHODS: At a private psychiatric hospital, we conducted a prospective high spatial resolution MRI study that included initial scans of 28 patients at their first hospitalization (13 with schizophrenia and 15 with affective psychosis, 13 of whom had a manic psychosis) and 22 healthy control subjects. Follow-up scans occurred, on average, 1.5 years after the initial scan. RESULTS: Patients with first-episode schizophrenia showed significant decreases in gray matter volume over time in the left Heschl gyrus (6.9%) and left planum temporale (7.2%) compared with patients with first-episode affective psychosis or control subjects. CONCLUSIONS: These findings demonstrate a left-biased progressive volume reduction in the Heschl gyrus and planum temporale gray matter in patients with first-episode schizophrenia in contrast to patients with first-episode affective psychosis and control subjects. Schizophrenia but not affective psychosis seems to be characterized by a postonset progression of neocortical gray matter volume loss in the left superior temporal gyrus and thus may not be developmentally fixed.     

Planum temporale and Heschl gyrus volume reduction in schizophrenia: a magnetic resonance imaging study of first-episode patients

BACKGROUND: Magnetic resonance imaging studies in schizophrenia have revealed abnormalities in temporal lobe structures, including the superior temporal gyrus. More specifically, abnormalities have been reported in the posterior superior temporal gyrus, which includes the Heschl gyrus and planum temporale, the latter being an important substrate for language. However, the specificity of the Heschl gyrus and planum temporale structural abnormalities to schizophrenia vs affective psychosis, and the possible confounding roles of chronic morbidity and neuroleptic treatment, remain unclear. METHODS: Magnetic resonance images were acquired using a 1.5-T magnet from 20 first-episode (at first hospitalization) patients with schizophrenia (mean age, 27.3 years), 24 first-episode patients with manic psychosis (mean age, 23.6 years), and 22 controls (mean age, 24.5 years). There was no significant difference in age for the 3 groups. All brain images were uniformly aligned and then reformatted and resampled to yield isotropic voxels. RESULTS: Gray matter volume of the left planum temporale differed among the 3 groups. The patients with schizophrenia had significantly smaller left planum temporale volume than controls (20.0%) and patients with mania (20.0%). Heschl gyrus gray matter volume (left and right) was also reduced in patients with schizophrenia compared with controls (13.1%) and patients with bipolar mania (16.8%). CONCLUSIONS: Compared with controls and patients with bipolar manic psychosis, patients with first-episode schizophrenia showed left planum temporale gray matter volume reduction and bilateral Heschl gyrus gray matter volume reduction. These findings are similar to those reported in patients with chronic schizophrenia and suggest that such abnormalities are present at first episode and are specific to schizophrenia.     

Reduced left angular gyrus volume in first-episode schizophrenia

OBJECTIVE: Research suggests that the normal left-greater-than-right angular gyrus volume asymmetry is reversed in chronic schizophrenia. The authors examined whether angular gyrus volume and asymmetry were abnormal in patients with first-episode schizophrenia. METHOD: Magnetic resonance imaging scans were obtained from 14 inpatients at their first hospitalization for psychosis and 14 normal comparison subjects. Manual editing was undertaken to delineate postcentral, supramarginal, and angular gyri gray matter volumes. RESULTS: Group comparisons revealed that the left angular gyrus gray matter volume in patients was 14.8% less than that of the normal subjects. None of the other regions measured showed significant group volume or asymmetry differences. CONCLUSIONS: Patients with new-onset schizophrenia showed smaller left angular gyrus volumes than normal subjects, consistent with other studies showing parietal lobe volume abnormalities in schizophrenia. Angular gyrus pathology in first-episode patients suggests that the angular gyrus may be a neuroanatomical substrate for the expression of schizophrenia.     

遗忘型轻度认知功能损害患者大脑皮质结构磁共振成像的改变

目的 运用MRI及FMRIB software library(FSL)和Freesurfer软件包分析技术,研究遗忘型轻度认知功能损害(amnestic mild cognitive impairment,aMCI)患者全脑皮质结构改变情况.方法 对20例aMCI患者和20名年龄、性别、文化程度相匹配的健康志愿者,应用SEMENTS trio3.0 T MRI仪,采用高分辨扫描技术获取大脑精细结构立体像,然后应用FSL软件和Freesurfer软件包进行数据分析和后处理,计算出全脑不同部位皮质密度和厚度,比较aMCI组与健康对照组皮质结构特征的区别.结果 与健康对照组相比,aMCI组的左侧额叶、顶叶、颞叶皮质密度显著降低,右侧丘脑、颞叶及左侧岛叶皮质密度轻度降低;aMCI组左侧前扣带回[(2.19±0.24)mm]、顶下小叶[(2.27±0.15)mm],双侧海马旁回[(2.03±0.15)、(2.04±0.17)mm]、额上回[(2.42±0.34)、(2.40±0.28)mm]、额中回[(2.31±0.31)、(2.33±0.29)mm]、颞极[(3.41±0.68)、(3.30±0.56)mm]、颞横回[(2.04±0.12)、(2.01±0.11)mm]、中央前回[(2.20±0.11)、(2.31±0.19)mm]、中央后回[(1.88±0.11)、(1.82±0.09)mm]、缘上回[(2.53±0.33)、(2.55±0.23)mm]的皮质厚度显著降低(t=2.13～3.75,P＜0.05),其余部位无明显改变(t=0.09～1.88,P＞0.05).结论 aMCI患者大脑多个部位存在皮质结构改变,皮质厚度的变薄早于密度的降低.