家族性和散发性首发精神分裂症患者及其父母的脑结构差异

目的应用优化的基于体素的形态学研究方法(voxel based morphometry,VBM)比较家族性和散发性首发精神分裂症患者及其父母的脑结构差异。方法纳入家族性精神分裂症患者10例,其父母8例;散发性精神分裂症患者10例,其父母12例。同时纳入20例正常对照。采用优化的VBM方法处理高分辨T1加权图像,最后用两样本t检验分别比较两组患者及两组患者父母之间的脑灰质密度的差别。结果与散发性患者相比,家族性精神分裂症患者双侧丘脑的灰质密度均有降低。家族性分裂症患者父母的双侧丘脑、右侧海马旁回、左侧海马及左侧颞上回灰质密度较散发性患者父母降低。与正常对照相比,家族性及散发性精神分裂症患者双侧岛、右侧颞叶、右侧枕叶、左侧苍白球、右侧小脑及左侧额叶直回的灰质密度降低。两组患者的父母组中,只有家族性患者父母的一些脑区(包括右侧丘脑)的灰质密度较正常对照降低。结论家族性精神分裂症患者的双侧丘脑灰质密度较散发性患者显著降低,为以往研究中发现的家族性和散发性精神分裂症患者临床症状学的差异提供了脑结构的神经影像学证据。同时,家族性患者父母双侧丘脑的灰质密度较散发性患者父母也有明显降低,这一结果说明两组患者丘脑结构的差异与遗传有较大的关系。

Brain Structural Differences of Schizophrenia Patients with and without Family Histories

Objective To identify the brain structural differences of schizophrenia patients and their parents between those with family history and those sporadic cases.Methods High resolution T1 weighted images were obtained using 3T MR from 10 familial patients and 10 sporadic patients matched with age,sex,years of education and duration of disease.All patients were in their first episode of care.Twenty unaffected parents of the patients(8 for familial cases,12 for sporadic cases)and 20 normal controls were also examined.The images were preprocessed according to the optimized VBM protocol.Student t test was performed to test the differences of the gray matter density(GMD)of the patients and their parents between the groups with and without family histories,and between the patient groups and the normal controls.Results Compared with the sporadic group,significant reduce of GMD was observed in bilateral thalamus in both familial schizophrenia patients and their parents.Compared with normal controls,both familial and sporadic schizophrenia patients showed lower GMD in many areas including bilateral insula,right temporal lobe,right occipital lobe,left lenticula,right cerebellum and left rectal gyrus extending to anterior cingulated gyrus.Only familial patients showed lower GMD in the right thalamus.Familial parents also showed lower GMD in several areas including right insula extending to right temporal lobe and right parietal lobule.Conclusion Familial schizophrenia is associated with genetically related structural abnormalities,especially in the bilateral thalamus.The brain structural differences can explain,at least in part,the symptom differences between familial and sporadic schizophrenia.