首发精神分裂症患者脑磁共振质子波谱的对照研究

目的研究首发精神分裂症患者脑磁共振质子波谱(1HMRS)的变化。方法对26例首发精神分裂症患者和12例正常人分别进行MRI常规扫描和1HMRS检查,1HMRS采用定点分辨率波谱序列(TR2000毫秒,TE135毫秒),所测定的代谢产物包括N-乙酰基天门冬氨酸(NAA)、肌酸复合物(Cr)、胆碱复合物(Cho)、肌醇(MI)、乳酸(Lac)、谷氨酸及谷氨酰胺(Glu-Gln)。结果精神分裂症患者前额叶背外侧回中NAA/Cr值和NAA/Cho值显著低于对照组前额叶背外侧回(1.83±0.15/2.42±0.13,t=3.202,P<0.01,2.37±0.16/2.06±0.24,t=2.453,P<0.05);患者组海马区中NAA/Cr值(1.65±0.19)和NAA/Cho值(1.12±0.21)显著低于对照组海马中的NAA/Cr值(1.83±0.27,t=2.532,P<0.05)和NAA/Cho值(1.34±0.12,t=2.641,P<0.05);且NAA/Cr的水平与简明精神障碍评定量表阴性症状总分呈负相关(r=-0.416,P<0.05);而丘脑、颞叶颞横回、枕叶脑区的NAA/Cr和NAA/Cho两组无显著性差异(P>0.05)。结论精神分裂症患者的1HMRS与正常人存在显著差异,提示精神分裂症存在神经元功能的异常,其前额叶背外侧回和海马两处脑区功能低下。

Proton Magnetic Resonance Spectroscopy of Brains in First-episode Schizophrenic Patients

Objective: To study the change of 1HMRS in first-episode and neuroleptic-naive patients with schizophrenia.Methods:26 patients and 12 healthy controls were selected to perform MRI and 1HMRS examination. Point resolved spectroscopy sequence(TR 2000msec, TE 135msec) was required for 1HMRS. The metabolites in the spectra includes N-acetylaspartate(NAA)?choline compounds(Cho)?creatine compounds(Cr)?myo-inositol(MI)?Lactate(Lac)?glutamate and glutamine(Glu-Gln).Results:A decrease of NAA/CR and NAA/Cho has been shown in both the dorsolateral prefrontal cortex and the hippocampus of schizophrenic patients; moreover NAA/Cr of dorsolateral prefrontal cortex are closely related with the total negative syndromes scales of BPRS; However, there are no statistically significant differences in metabolite levels in thalamus?temporal lobes and occipital lobe between patients and controls.Conclusion:There is significant difference of manifestation of 1HMRS between schizophrenic patients and normal persons,which supports the brain dysfunction in schizophrenia.