未服药精神分裂症患者内囊前肢MRI扩散张量成像研究

Diffusion tensor imaging study of the anterior limb of internal capsules in neuroleptic-na(?)ve schizophrenia

目的应用磁共振扩散张量成像比较未服药精神分裂症患者和健康对照者两侧内囊前肢FA值和ADC值的的差异。方法本研究对21例未服药的精神分裂症患者(病例组)和18名年龄和性别相匹配的健康人(对照组)进行MRI常规序列成像和扩散张量成像,采用小ROI法测量病例组和对照组的左、右侧内囊前肢的各向异性分数(FA值)和ADC值,并比较两组左、右侧内囊前肢FA值和ADC值的差异。结果病例组左、右侧内囊前肢的FA均数分别为0.598±0.041和0.611±0.041,左、右侧的ADC均数分别为(7.292±0.363)×10^(-4)mm^2/s,(7.299±0.305)×10~4mm^2/s,对照组左、右侧内囊前肢FA均数分别为0.626±0.033和0.650±0.057,左、右侧ADC平均数分别为(7.073±0.543)×10^(-4)mm^2/s,(7.147±0.642)×10^(-4)mm^2/s,采用成组独立样本的t检验,双侧95%的可信区间,病例组与对照组两侧内囊前肢的FA均数具有统计学意义(P<0.05),分裂症组的两侧内囊前肢FA平均数低于对照组;两组的ADC均数无统计学意义。结论未服药精神分裂症患者两侧内囊前肢的白质微观结构的改变,提示两侧丘脑与前额叶、扣带回前部的相互联系的白质功能障碍,可以解释精神分裂症的一些临床症状和认知缺陷。

Objective To evaluate whether white matter abnormality present in neuroleptic-naive schizophrenic patients - with diffusion tensor imaging （DTI）. Methods Twenty-one neuroleptic-naive schizophrenic patients and 18 matched healthy controls were studied using DTI. We measured and compared fractional anisotropy （FA） and average diffusion coefficient （ADC） in the bilateral anterior limb of internal capsules. Results Compared to healthy controls, neuroleptic-naive schizophrenic patients showed significantly reduced FA in the bilateral anterior limb of internal capsule. Difference of ADC in the bilateral anterior limb of internal capsule in two groups were not detected. Conclusion The reduced FA of the bilateral anterior limb of internal capsule is suggested bilateral thalamus-frontal connection distruption in neuroleptie-naive schizophrenic patients.