首发偏执型精神分裂症全脑磁共振质子波谱分析

The fractional anisotropy of metabolites of the brain in first--episode patients with paranoid schizophrenia： A study of MRS

目的探讨未用药首发偏执型精神分裂症患者的多个兴趣区灰质的磁共振氢质子波谱分析（MRS）的特点，以期为精神分裂症“神经发育异常假说”提供依据。方法选取20例首发偏执型精神分裂症患者，应用MRS技术对11个兴趣区的白质或灰质进行脑内神经生化代谢物检测，并与20例年龄、性别和文化程度与患者相匹配的健康对照者比较。结果与对照组比较，患者组双侧额叶皮质的NAA值、Cho值和NAA/Cr、Cho/Cr比率，左侧颞叶Cho值和NAA/Cr，胼胝体膝部和左侧小脑中脚的NAA值和Cho值，右侧丘脑和双侧尾状核Cho值（P〈0.05）。结论首发偏执型精神分裂症患者脑内胼胝体膝部和左侧小脑中脚发生了弥漫性轴突损害，支持精神分裂症神经发育异常的神经病理假说。

Objective To evaluate the metabolites in some regions of interest （ROI） in the brain of the first--episode patients with paranoid schizophrenia, and aim at demonstrating the neurodevelopment hypothesis of schizophrenia. Methods Twenty first--episode patients with paranoid schizophrenia and twenty health controls paired with sex, age （±3 years old） and education were scanned by multi--vowel proton MR. The spectra were obtained from a 1.5 T MR scanner by PRESS sequence with TR/TE of 1000/144ms. The metabolite peaks of N- acetylasparate （NAA）, cholinecontaining compound （Cho）, and ereatine--phosphocreatine （Cr） were measured in 11 ROIs. The comparison of the above variables between the two groups were conducted by SPSS software. Results Compared to the health control group, the values of NAA, Cho and the ratio of NAA/Cr, Cho/Cr in bilateral frontal lobe, the value of Cho and the ratio of NAA/Cr in left temporal lobe, the values of NAA, Cho in the lap of corpus callsum and left middle cerebella peduncle, and the values of Cho in bilateral caudate nucleus and right thalamus were significant lower （P 〈 0.05）. Conclusions The diffusive damage of axon in the lap of corpus caltosum and left middle cerebella peduncle in the first--episode patients with schizophrenia were found, demonstrating the possible pathphysiology of the neurodevelopment hypothesis in schizophrenia.