偏执型精神分裂症和双相情感障碍躁狂患者脑灰质体积的比较分析

A Comparative Study of Voxel-based Morphometry in Patients with Paranoid Schizophrenia and Bipolar Mania

目的采用优化的基于体素的形态学(voxel based morphometry,VBM)方法,比较偏执型精神分裂症、双相情感障碍躁狂患者脑灰质体积的差异。方法运用3.0T磁共振扫描仪对符合美国精神障碍诊断统计手册第4版(DSM-Ⅳ)诊断标准的20例偏执型精神分裂症住院患者、20例双相情感障碍躁狂相住院患者和20例正常对照进行3D T1像扫描。在SPM2平台上,以优化的VBM方法对高分辨T1加权图像进行处理,比较上述研究对象脑灰质体积的差异。结果与正常对照比较,偏执型精神分裂症患者右侧颞中回、颞下回,左侧颞上回灰质体积减少,而双侧额下回、双侧屏状核灰质体积增加。双相情感障碍躁狂患者与正常对照比较出现灰质体积减少的脑区包括双侧尾状核,右侧颞叶颞上、中、下回,灰质体积增加的脑区包括左侧顶叶中央后回、双侧楔前叶、右侧额上回、左侧扣带回。偏执型精神分裂症患者与双相情感障碍躁狂患者相比左侧颞上回、左侧额下回、右侧尾状核体灰质体积增加。结论偏执型精神分裂症患者与双相情感障碍躁狂患者既存在不同脑区的灰质体积的改变,也存在共同的右侧颞叶灰质体积改变。

Objective To assess volumetric abnormalities of grey matter in the brains of patients with paranoid schizophrenia and bipolar disorder（mania）. Methods 3D T1 weighted images were acquired by magnetic resonance imaging from 20 patients with paranoid schizophrenia, 20 patients with bipolar disorder（mania） and 20 control subjects. Regional deviation in grey matter volume was assessed using optimized volumetric voxel-based morphometry. ANOVA was performed to test the difference of the gary matter volume （GMV）. Results Compared with controls, the patients with paranoid schizophrenia showed decreased gray matter volume in left superior temporal gyrus, right middle temporal gyrus and inferior temporal gyrus, and increased gray matter volume in bilateral inferior frontal gyrus and bilateral claustrum. Whereas, the patients with bipolar disorder （mania） showed decreased gray matter volume in right superior temporal gyrus, middle temporal gyrus, inferior temporal gyrus and bilateral caudate, and increased gray matter volume in bilateral precuneus, left postcentral gyrus, right superior frontal gyrus and left cingulated gyrus. The patients with paranoid schizophrenic patients had greater gray matter volume in left inferior frontal gyrus, left superior temporal gyrus and right caudate than the patients with bipolar disorder. Conclusion Patients with sehizophrenic and bipolar disorder have different changes in brain structure. However, they also share the same reduction of GDV in right temporal gyrus.