首发和慢性精神分裂症脑白质的弥散张量成像

目的 分析首发精神分裂症和慢性精神分裂症脑白质完整性变化.方法 2009年8月至2011年2月在中山大学附属第三医院精神科住院部或门诊部就诊的39例首发精神分裂症患者、38例慢性精神分裂症患者和广告招募的69名健康对照进行脑磁共振弥散张量成像,3组图像以基于体素的分析方法进行单因素方差分析,提取阳性结果区平均FA值再进行多重比较.结果 (1)首发精神分裂症、慢性精神分裂症和健康对照在以下脑区的白质FA值存在差异:右侧尾状核区域(MNI:20、12、14,cluster=432 voxels,FA值:0.36±0.18比0.35±0.24比0.38±0.17);左侧岛叶区域(MNI:-32、18、2,cluster=204 voxels,FA值:0.35±0.31比0.33±0.24比0.36±0.21);右侧前扣带区(MNI:16、36、12,cluster=132 voxels,FA值:0.35±0.29比0.34±0.31比0.37±0.25).(2)两患者组上述脑区的白质平均FA值均低于健康对照组(均P＜0.05).(3)慢性精神分裂症左侧岛叶区的白质平均FA值低于首发精神分裂症(P＜0.05),另两脑区FA值两组间差异无统计学意义.结论 脑白质完整性异常与精神分裂症的发病机制可能有关,且可能进行性发展.

Abstract：

Objective To investigate the integrity of white matters in first-episode and chronic schizophrenics. Methods For this study, 39 first-episode and 38 chronic schizophrenics, 69 healthy controls (age, gender and years of received education no significantly different from those of the patients)underwent diffusion weighted images with a single-shot echo planar imaging (EPI) sequence aligned to the straight axial plane. The fractional anisotropy (FA) images of three groups underwent one-way ANOVA with the methods of voxel-based morphometric (VBM) analysis. Results ( 1 ) There were three brain regions where the FA values of white matter were different among three groups: right caudate nucleus ( MNI:20, 12,14; cluster = 432 voxels; FA value :0. 36 ± 0. 18 vs 0. 35 ± 0. 24 vs 0. 38 ± 0. 17 ), left insula ( MNI: - 32,18, 2; cluster =204 voxels; FA value:0. 35 ±0.31 vs 0.33 ±0.24 vs 0.36 ±0.21) and right anterior cingulated( MNI: 16, 36, 12; cluster = 132 voxels;FA value:0. 35 ±0. 29 vs 0. 34 ±0. 31 vs 0. 37 ±0. 25).(2)The mean FA values of the three brain regions of two patients groups decreased versus those of healthy controls (P ＜0. 05 ). (3)The mean FA values of left insular region in chronic patients decreased versus those of the first-episode patients ( P ＜ 0. 05 ). Conclusion The reduced integrity of white matter may play an etiological role in schizophrenia and the changes are probably progressive.

Diffusion tensor imaging findings in first-episode and chronic schizophrenics

Objective To investigate the integrity of white matters in first-episode and chronic schizophrenics. Methods For this study, 39 first-episode and 38 chronic schizophrenics, 69 healthy controls (age, gender and years of received education no significantly different from those of the patients)underwent diffusion weighted images with a single-shot echo planar imaging (EPI) sequence aligned to the straight axial plane. The fractional anisotropy (FA) images of three groups underwent one-way ANOVA with the methods of voxel-based morphometric (VBM) analysis. Results ( 1 ) There were three brain regions where the FA values of white matter were different among three groups: right caudate nucleus ( MNI:20, 12,14; cluster = 432 voxels; FA value :0. 36 ± 0. 18 vs 0. 35 ± 0. 24 vs 0. 38 ± 0. 17 ), left insula ( MNI: - 32,18, 2; cluster =204 voxels; FA value:0. 35 ±0.31 vs 0.33 ±0.24 vs 0.36 ±0.21) and right anterior cingulated( MNI: 16, 36, 12; cluster = 132 voxels;FA value:0. 35 ±0. 29 vs 0. 34 ±0. 31 vs 0. 37 ±0. 25).(2)The mean FA values of the three brain regions of two patients groups decreased versus those of healthy controls (P ＜0. 05 ). (3)The mean FA values of left insular region in chronic patients decreased versus those of the first-episode patients ( P ＜ 0. 05 ). Conclusion The reduced integrity of white matter may play an etiological role in schizophrenia and the changes are probably progressive.