首发精神分裂症患者脑磁共振质子波谱的对照研究

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

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。

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 I HMRS. 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.