阳性症状为主型首发精神分裂症患者脑磁共振质子波谱的偏侧性研究

目的 探讨未经药物治疗的首发精神分裂症阳性症状为主型患者双侧额叶、海马的多体素氢质子波谱(1H-MRS)的变化特点.方法 应用1H-MRS成像技术,检测20例首发精神分裂症阳性症状为主型患者双侧额叶、海马的N-乙酰天冬氨酸复合物(NAA)、胆碱复合物(Cho)和肌酸-磷酸肌酸复合物(Cr)含量,对NAA/Cr、Cho/Cr、NAA/Cho比值进行计算.以配对t检验方法进行统计分析.结果 (1)首发精神分裂症阳性症状为主型患者右利手,左侧额叶白质Cho/Cr(1.178±0.210)小于右侧(1.437±0.337),差异有统计学意义(P＜0.05).(2)双侧扣带回前部各代谢物差异均无统计学意义(P＞0.05).(3)左侧海马头NAA/Cr(1.339±0.452)和Cho/Cr(1.406±0.394)小于右侧(1.748±0.147,1.761±0.362),差异有统计学意义(P＜0.05).结论 精神分裂症阳性症状为主型患者可能存在左侧额叶和海马代谢异常,支持精神分裂症的脑偏侧性假说.

A 1H magnetic spectroscopy study in the first-episode patients with positive symptoms of schizophrenia

Objective To identify the possible alterations of brain function in prefrontal lobes and hippocampus in the first-episode patients with positive symptoms of schizophrenia using magnetic resonance spectroscopy. Methods 20 patients were selected to perform MRI and HMRS examination. Proton multi-voxel spectroscopy imaging(1 H-MRSI)was obtained from two sides of the hippocampus and frontal lobes regions. The metabolites included N-acetylaspartate (NAA), and choline-containing compounds (Cho), creatine and phosphocreatine (Cr).The ratios of NAA/Cr, Cho/Cr and NAA/Cho were determined. Results (1)The Cho/Cr ratio was significantly reduced in left frontal white matter of patients compared to right(1. 178 ± 0.210 vs 1.437 ± 0. 337). (2) There was no statistically significant difference in metabolite levels in between left anterior cingulate gray matter and right (N AA. Cr: 1. 339 ± 0.452 vs 1. 748 ± 0. 147;Cho/Cr: 1. 406 ± 0. 394 vs 1. 761 ± 0.362) (P ＜ 0.05). (3) The NAA/Cr, Cho/Cr were significantly reduced in left hippocampus of patients compared to right. Conclusion The results implicate that the metabolic abnormalities might exist in the left hippocampus and frontal lobe of schizophrenic patients with positive symptoms.