慢性精神分裂症磁共振弥散张量成像及其与临床症状的相关分析

The abnormality of white matter and correlation with clinical symptoms in chronic schizophrenia

目的探讨慢性精神分裂症脑白质磁共振弥散张量成像（diffusion tensor imaging，DTI）的特点及其与相关临床特征的关系。方法收集慢性精神分裂症患者22例（疾病组）和健康志愿者16名（对照组），两组年龄、性别、受教育年限差异无统计学意义（P〉0．05），数据采集预处理后，采用独立样本t检验比较疾病组和对照组全脑白质各向异性分数（fractional analysis，FA）图像，并分析患者脑白质FA值与临床特征的相关性。结果（1）疾病组较对照组FA增加的脑区域有：右颞中回（t：4．64，P〈0．001）；疾病组较对照组FA降低的脑区域有：左额下回（t=-5．41，P〈0．001），右颞上回（t=-4．57，P〈0．001），右颞横回（t=-4．30，P〈0．001），右海马回（t=-4．08，P〈0．001），左岛叶（t：-4．13P〈0．001）；（2）右颞上回（r=-0．538．P=0．01）、右颞横回（r=-0．507，P=0．016）、右海马回（r=-0．434，P=0．043）的FA值均与病程呈负相关。结论慢性精神分裂症可能存在大脑白质纤维的异常；病程的长短可能与患者脑区异常有关，即病程越长，脑区异常越明显。

Objective To investigate the abnormality of white matter by diffusion tensor imaging （DTI） and correlation with clinical symptoms in chronic schizophrenia. Methods Twenty-two chronic schizophrenia patients and 16 age-, gender- and education-matched healthy controls were recruited. Correlation analysis was used to explore the relationship between abnormal brain regions and clinical symptoms of chronic schizophrenia. Results Compared with controls, patients had significant increased fractional analysis （ FA ） in right cerebrum middle temporal gyrus （ t = 4.64, P 〈 0. 001 ） and decreased FA in left cerebrum inferior frontal gyrus （ t = - 5.41, P 〈 0. 001 ） , right cerebrum superior temporal gyrus （ t = -4.57 ,P 〈0. 001 ） , right cerebrum transverse temporal gyrus （ t = - 4.30, P 〈 0. 001 ） , fight cerebrum hippocampal gyms （ t = - 4.08 P 〈 0. 001 ） , and left insular lobe （ t = - 4.13, P 〈 0. 001 ）. The FA of right cerebrum superior temporal gyrus （r = -0. 538 ,P = 0. 01 ）, right cerebrum transverse temporal gyrus （r = -0. 507 ,P = 0. 016 ） and right cerebrum hippocampal gyrus （ r = - 0. 434, P = 0. 043 ） had significantly negative correlation with illness duration. Conclusions Chronic schizophrenia patients might have white matter abnormalities.