未经治疗的首发精神分裂症患者脑灰质非对称性改变:基于VBM的MRI结构研究

A VBM Study of the Brain Asymmetric Changes in First-episode,Antipsychotic-naive Schizophrenia Patients

目的:采用核磁共振成像及优化的基于体素形态学研究(voxel based morphometry,VBM)新技术分析未经治疗的首发精神分裂症患者的脑结构非对称性改变。方法:对符合DSM-IV精神分裂症诊断标准,同时未经药物治疗的首发精神分裂症住院患者以及正常志愿者各20例进行核磁共振扫描脑结构成像及基于VBM的脑非对称性分析。结果:病例组较正常对照显示出明显的正常非对称性减低甚至反转的改变。正常右利手左半球优势区域如额上回、颞中回、扣带回、眶回、尾状核头以及丘脑的非对称性下降;中央后回非对称性反转;海马及海马旁回的右大于左的非对称性增加。结论:脑非对称性在未用药物治疗的首发精神分裂症患者中有明显的异常改变,提示精神分裂症患者存在原发的脑结构非对称性异常,脑非对称性紊乱的存在反映了神经异常发育与精神分裂症的发病的关联。精神分裂症患者存在的脑结构非对称性异常可能构成了精神分裂症的神经生物学表征。

Objective：To probe the brain asymmetry in first-episode,antipsychotic-naive schizophrenia patients by applying optimized voxel based morphometry（VBM）using high resolution T1 weighted MR images.Methods：High-resolution volumetric T1-weighted images were acquired from 20 first-episode schizophrenia patients and 20 age-and gender-matched healthy control subjects.Images were processed using optimized voxel-based morphometry.Results：Compared with healthy volunteers, patients demonstrated prominent L〉R grey matter asymmetry decrease in cingulated gyrus（mainly in posterior cingulate cortex）,head of caudate nuclear,thalamus,superior frontal gyrus（SFG）,orbital gyrus（OG）,and middle temporal gyrus（MTG）in color-coded digital map.The asymmetry of postcentral gyrus in the patient group reversed.There were right〉left（R〉L）asymmetry of hippocampus,parahippocampal gyrus and superior temporal gyrus（STG）regions in normal controls.While in patient group,the normal right〉left asymmetry in superior temporal gyrus（STG）was lost,while that in hippocampus andparahippocampal gyrus became more evident.Conclusion：Our study provided evidence for cerebral asymmetry changes in first-episode,antipsychotic-naive schizophrenia patients.The disruptions are highly consistent with schizophrenia functional deficits,supporting the neurodevelopmental hypothesis of its etiology.