精神分裂症首次发病患者的脑扩散张量成像研究

Diffusion tensor imaging in patients with first episodic schizophrenia

目的利用磁共振扩散张量成像（DTI）技术研究未经药物治疗的精神分裂症首次发病（以下简称首发）患者主要脑区白质纤维束的异常。方法选取26例首发精神分裂症患者（患者组）和20名健康志愿者（对照组）行脑DTI扫描（两组均为右利手），测量胼胝体膝部、压部、双侧额叶白质、扣带束前部及海马头的部分各向异性（FA）值。结果（1）对照组左侧扣带束FA值（0．428±0．067）大于右侧（0．375±0．079；P〈0．05）。（2）患者组两侧相对应感兴趣区FA值差异均无统计学意义（P〉0．05）。（3）患者组左右侧胼胝体压部FA值（均为0．734±0．085）、左右侧扣带束前部FA值（0．300±0．068和0．306±0．062）均低于对照组（0．785±0．045，0．428±0．067，0．375±0．079：均P〈0．05）。结论首发精神分裂症患者存在双侧扣带束、胼胝体压部白质纤维束的受损，支持脑内连接异常假说。

Objective To study the abnormality of white matter tracts in patients with first-episodic schizophrenia by using diffusion tensor imaging （DTI）. Methods DTI was performed in 26 patients with first episodic schizophrenia and 20 normal comparison subjects, and the fractional anisotropy （FA） values were subsequently measured in multiple brain regions. Results There was a remarkable left-greater-than- right asymmetry anisotropy in the anterior cingulum bundles in controls （P〈0.05） , while reduced FA was seen in both sides of the anterior cingulum in patients （P〈 0.05 ）. Lower FA in splenium of corpus callosum was in patients than in controls （ P 〈 0. 05 ）. Conclusions The patients with first-episodic schizophrenia may have a lack of normal left-greater-than-right asymmetry and aberrant callosal connectivity.