精神分裂症早期的脑白质和灰质信号强度下降

The decrease of white matter and gray matter density in the early stage of first episode schizophrenia

目的分析精神分裂症早期阶段脑灰质和脑白质结构的变化。方法对25例早期阶段(病程小于6个月)的首发未用药的精神分裂症患者和28名正常对照的脑部进行磁共振T1加权成像,所得图像以统计参数图软件包进行预处理,再对两组脑灰质密度和白质信号强度进行t检验。结果患者组左侧岛叶区(x=34,y=18,z=-2,体素集合数=163)、左枕叶(x=14,y=-66,z=14,体素集合数=76)、右侧额叶(x=46,y=44,z=8,体素集合数=74)白质信号强度较正常对照组降低(t=-3.78,P=0.007;t=-3.36,P=0.02;t=3.26,P=0.03);右侧枕叶(x=10,y=-84,z=8,体素集合数=64)脑灰质信号强度比正常对照组降低(t=3.12,P=0.03)。结论精神分裂症早期阶段即存在脑实质结构异常,以白质为著。

Objective To investigate whether structural abnormalities are present in the whole gray matter or white matter in early stage of schizophrenia. Methods Twenty-five patients in the early stage （with the course of less than 6 months） of first-episode-schizophrenia and 28 healthy controls were examired with T1 weighted magnetic resonance imaging. Scans were normalized,uniformed segmented and smoothed using the statistical parametric mapping 5 （SPM5）,and the gray matter and white matter densities were compared by two-sample t-test with SPM5 software. Results The patients demonstrated significant decrease of the white matter density in left insula（x=34,y=18,z=-2,cluser=163 voxels,t=-3.78,P=0.007））,left occipital lobe（x=14,y=-66,z=14,cluster=76 voxels,t=-3.36,P=0.02）,and right frontal lobe（x=46,y=44,z=8,cluster=74 voxels,t=3.26,P=0.03）. The patients demonstrated significant decrease of the gray matter density in right occipital lobe（x=10,y=-84,z=8,cluster=64 voxels,t=3.12,P=0.03）. Conclusions During the early stage of first-episode schizophrenia,there are structural abnormalities in the white matter and gray matter,especially in the white matter.