早发精神分裂症全脑灰质体积的变化

Changes of Gray Matter Volumes in Patients with Early-onset Schizophrenia

【目的】研究早发精神分裂症患者全脑灰质结构的变化。【方法】对2009年6月至2010年11月共21例发病年龄小于18岁的精神分裂症患者和22例在年龄、性别、受教育年限与患者组相均衡的健康对照纳入研究。对所有受试者首先以1.5T磁共振系统以冠状自旋回波序列进行全脑T2加权和质子密度加权图像,排除全脑器质性病变。然后以矢度梯度回波序列得到T1加权成像。T1加权图像经MRIcro软件转化为统计参数图-V(SPM5)软件可以处理的图像。以SPM5软件对转化后图像进行基于体素形态学分析(VBM),完成标准化、分割、调整和平滑等步骤。对患者组和健康对照组的平滑后灰质图像以VBM方法进行两样本t检验。以阳性和阴性症状量表评估患者精神症状。【结果】早发精神分裂症患者组灰质体积小于健康对照组的脑区有:右侧额下回(MNI:43,20,-14;cluser=407voxels)、左侧额上回(MNI:-28,-3,65;cluser=176voxels)、右侧额上回(MNI:48,-10,54;cluser=141voxels);未发现患者组灰质体积大于健康对照组的脑区。【结论】早发精神分裂症存在右侧额下回和双侧额上回灰质异常,此异常改变可能与精神分裂症的神经病理机制有关。

[Objective]To investigate the changes of the gray matter volumes in patients with early-onset schizophrenia（EOS）.[Methods] The subjects were 21 patients with EOS（the onset of psychotic symptoms occurred before 18 years of age） and 22 healthy controls（age,sex,and years of received education were no significantly different from those of patients）.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.Symptoms were assessed using the Positive and Negative Syndrome Scale（PANSS）.[Results] EOS patients presented significantly reduced GM volume in the right inferior frontal cortex（MNI：43,20,-14;cluster = 407 voxels）,left superior frontal cortex（MNI：-28,-3,65;cluster = 176 voxels） and right superior frontal cortex（MNI：48,-10,54;cluster = 141voxels）,compared with the healthy controls.[Conclusions] Volumes of gray matter in EOS were decreased in right inferior and bilateral superior frontal cortex.These abnormal changes may be involved in the neuropathology of schizophrenia.