精神病未治疗期长短对首发精神分裂症脑灰质的影响

Effect of duration of untreated psychosis on gray matter in untreated first-episode schizophrenia

目的分析精神病未治疗期（ duration of untreated psychosis, DUP对精神分裂症患者局部脑灰质结构的影响。方法39例首发未服药精神分裂症患者根据DUP分为长DUP组和短DUP组。所有受试者接受T1加权成像扫描。所得图像经MRIcro软件转化为统计参数图（Statistical Parametric Mapping—V，SPM5）软件可以处理的图像。然后以SPM5软件进行图像的标准化、分割、调整和平滑等步骤。对两组的平滑后灰质图像以VBM方法进行两样本t检验。结果①长DUP患者左侧丘脑区（MNI：-6，-16，2；cluster=141 voxels）、左侧颞叶区（MNI：-46，-58，-6；cluster=69 voxe]s）灰质体积较短DUP患者下降。②未发现长DUP患者有脑区灰质体积较短DUP患者增高。结论发病后未治疗时间的延长会加重精神分裂症患者的脑灰质结构障碍。

Objective To investigate the association of duration of untreated psychosis （DUP） and the graymatter volumes in patients with first-episode schizophrenia. Methods 39 patients with first-episode schizophrenia were divided into two groups according to DUP： long-DUP group and short-DUP group. All the subjects underwent T1 weighted magnetic resonance imaging. After transformed with MRIcro software,all the images underwent standardization, segmentation, modulation and smoothing with Statistical Parametric Mapping 5 （SPM5） software. The gray matter volumes of the two groups underwent two-sample t -test with a Voxel-based morphometry （VBM） using SPM5 software. Results Long-DUP schizophrenic patients presented significantly reduced GM volume in the left thalamus（ MNI ： - 6, - 16,2 ; cluster = 141 voxels） and the left temporal lobe （ MNI ： - 46, - 58, - 6 ; cluster = 69 voxels）, compared with short-DUP schizophrenic patients. Conclusion Delayed DUP may increase the loss of gray matter in schizophrenia.