首发精神分裂症阳性症状为主型患者脑弥散张量成像研究

An isotropic study of cerebral white matter fiber tracts in patients with positive symptoms of first-onset schizophrenia

目的探讨首发精神分裂症阳性症状为主型患者主要脑区白质纤维束有无异常。方法对未系统使用过精神药物治疗的20例首发精神分裂症阳性症状为主型患者和20名正常对照进行磁共振弥散张量成像(DTI)扫描,测量胼胝体膝部、压部、双侧额叶白质、双侧扣带束前部和双侧海马头部分各向异性(FA)值。结果①患者组及对照组组内比较,左右侧FA值差异均无统计学意义(P>0.05)。②患者组左侧海马头和胼胝体压部FA值[(0.17±0.03),(0.73±0.09)]显著低于对照组[(0.20±0.02),(0.79±0.05)],差异均有统计学意义(P<0.05);③患者组左右侧扣带束前部FA值[(0.28±0.06),(0.29±0.05)]低于对照组[(0.43±0.07),(0.38±0.08)],差异均有统计学意义(P<0.01)。结论首发精神分裂症阳性症状为主型患者双侧扣带束前部、胼胝体压部及左侧海马头的白质纤维束完整性受损,提示其可能存在脑神经发育连接异常。

Objective To measure white matter fiber tracts in some brain regions using the diffusion tensor imaging （DTI） in first-onset schizophrenic patients with positive symptoms. Methods DTI was performed in 20 first-onset patients with positive symptoms of schizophrenia and 20 normal controls. Fractional anisotropy （FA） values were subsequently measured in the genu and splenium of corpus callosum, bilateral frontal white matter, bilateral anterior cingulate fasciculus and bilateral head of the hippocampus. Results （1） No differences of FA values of DTI between left and right sides were found in either patients or controls （ P 〉 0. 05 ）. （2） FA values of DTI significantly decreased in the head of the left side hippocampus and splenium of corpus callosum in schizophrenic patients [ （ 0. 17 ± 0. 03 ） , （ 0. 73 ± 0.09 ） ] than in controls [ （0. 20 ±0.02）, （0. 79 ±0. 05） ] （P 〈0.05）. （3） FA values of DTI were significantly lower in the bilateral anterior cingnlate fasciculus in schizophrenic patients[ （0. 28 ±0.06）, （0. 29 ± 0. 05 ） ] than in controls [ （0. 43 ± 0. 07 ）, （0. 38 ± 0. 08 ） ] （P 〈 0. 01 ）. Conclusions Integrity of white-matter fiber is disrupted in the bilateral anterior cingulate fasciculus, splenium of corpus callosum, and the head of the left side hippocampus in patients with positive symptoms of first-onset schizophrenia. There are abnormalities of neurodevelopmental connectivity in patients with positive symptoms of first-onset schizophrenia.