首发未服药精神分裂症患者脑弥散张量成像的基于体素分析

A voxel-based diffusion tensor imaging study of first-episode medication-free patients with schizophrenia

目的分析首发未服药精神分裂症患者脑白质完整性的变化。方法对40例首发未服药精神分裂症患者和68例健康对照者进行脑弥散张量磁共振成像检查，以DTI-studio软件和统计参数图（SPM）软件对所得图像进行预处理，得到的各向异性分数（FA）图像在SPM软件中进行两样本t检验．获得两组患者FA值差异统计参数图。结果在P值小于0．001（未校正）水平下。首发未服药精神分裂症患者右侧杏仁核区（MNI：24，2，-14，cluster=347voxels）、双侧前扣带区（MNI：6，42，2，cluster=586voxels）、右侧前额叶眶上回区域（MNI：20，18，-10，cluster=166voxels）白质FA值较健康对照者下降，且未发现前者有脑区白质FA值较后者增高。结论精神分裂症患者皮层一边缘系统环路存在结构连接障碍，这可能是精神分裂症的神经机制。

Objective To explore the changes of white matter integrity in first-episode medication-free patients with schizophrenia. Methods Diffusion tensor images （DTI） of whole brains of 40 first-episode medication-free patients with schizophrenia and 68 healthy controls were acquired with a single-shot echo planar imaging （EPI） sequence aligned to the straight axial plane. Two-sample t-test by with voxel-based analysis in SPM5 sottware was performed on the fractional anisotropy （FA） images of the 2 groups after being preprocessed with DTI-studio and SPM5 software. Results Subjects of schizophrenia showed reduced white matter FA in these regions： the right amygdale （MNI： 24, 2, -14; cluster=347 voxels）, bilateral anterior cingulate （MNI： 6, 42, 2; cluster=586 voxels）, right orbitofrontal （MNI： 20, 18, -10; cluster=166 voxels） as compared with healthy controls. Conclusion Abnormal white matter in the corticolimbic system circuit exists in patients with schizophrenia, which maybe involve in the neural mechanism of schizophrenia.