精神分裂症患儿颅脑结构异常与认知功能的关系

Relationship of Abnormal Brain Structure and Cognitive Changes in Childhood Schizophrenia

目的调查精神分裂症患儿颅脑结构异常和认知功能的关系。方法选择55例首发精神分裂症患儿和39名健康儿童为研究对象,利用MRI进行颅脑结构测量,用《中国修订韦氏儿童智力量表手册》(C-WISC)评估其认知功能。结果 1.精神分裂症患儿第三脑室横径、侧脑室前脚间距、左右颞角宽度、左右外侧裂脑沟根部宽、额叶和顶叶脑沟宽均高于健康对照组(Pa<0.05),胼胝体厚低于健康对照组(P<0.05);2.精神分裂症患儿第三脑室横径与常识、领悟、算术、数字广度、言语总分、言语智商(VIQ)、全量表分及全量表智商(FIQ)均呈负相关(Pa<0.05),第三脑室侧壁至左右脑岛面距、侧脑室前脚间距、侧脑室体最大距与常识均呈负相关(Pa<0.05),左右颞角宽度与常识、算术、言语总分、VIQ、全量表分及FIQ均呈负相关(Pa<0.05),左右外侧裂脑沟根部宽与常识、算术、数字广度、言语总分、VIQ、全量表分及FIQ均呈负相关(Pa<0.05),额叶脑沟宽与算术、言语总分及VIQ均呈负相关(Pa<0.05),顶叶脑沟宽与常识、算术、言语总分及VIQ均呈负相关(Pa<0.05),胼胝体厚与常识呈正相关(P<0.05)。结论精神分裂症患儿存在显著的脑室扩大和脑结构异常,脑室扩大和脑结构异常与认知损害存在相关关系,脑室扩大和脑结构异常越明显,认知损害越严重。

Objective To survey the relationship of abnormal brain structure and cognitive assessment in childhood schizophrenia. Methods Fifty-five patients with childhood schizophrenia were studied with magnetic resonance imaging for brain structural measurement,who were compared with the normal control group（n=39）.Their cognitive assessment were measured by Chinese Wechsler Intelligence Scale for Children（C-WISC）. Results 1.Compared with the controls,patients had significantly higher transverse diameter of third ventricle and width of lateral ventricle anterior horn and width of left horn of temporal and width of right horn of temporal and width of left lateral fissure and width of right lateral fissure and width of frontal sulci and width of parietal sulci（Pa0.05） and lower depth of corpus callosum（P0.05）.2.The transverse diameter of third ventricle was significantly negatively correlated with the score of common sense,comprehension,arithmetic,digit span,verbal scores,verbal intelligence quotient（VIQ）,full measuring scale scores and full intelligence quotient（FIQ）（Pa0.05）.The distances from lateral wall of third ventricle to left surface of insula and to right surface of insula and the width of lateral ventricle anterior horn and the largest width of lateral body were significantly negatively correlated with the score of common sense（Pa0.05）.The width of left horn of temporal and right horn of temporal were significantly negatively correlated with the score of common sense,arithmetic,verbal scores,VIQ,full measuring scale scores and FIQ（Pa0.05）.The width of left lateral fissure and right lateral fissure were significantly negatively correlated with the score of common sense,arithmetic,digit span,verbal scores,VIQ,full measuring scale scores and FIQ（Pa0.05）.The width of frontal sulci was significantly negatively correlated with the score of arithmetic,verbal scores and VIQ（Pa0.05）.The width of parietal sulci was significantly negatively correlated with the score of common sense,arithmetic,verbal scores and VIQ（Pa0.05）.The depth of corpus callosum was significantly positively correlated with the score of common sense（P0.05）. Conclusions Patients with childhood schizophrenia have significant ventricular enlargement and abnormal brain structure.Cognitive functions of childhood schizophrenia are significantly correlated with ventricular enlargement and abnormal brain structure,and the marked ventricular enlargement and abnormal brain structure will do more harm to the cognitive impairment.