精神分裂症首次发病患者前联合的弥散张量纤维束成像研究

Diffusion tensor tractography of anterior commissural fibers in patients with first-episode schizophrenia

目的研究精神分裂症首次发病患者前联合白质结构的完整性，探索其与精神分裂症症状问的关系。方法对24例精神分裂症首次发病患者（患者组）、29名健康者（对照组）行弥散张量成像（diffusion tensor imaging，DTI）扫描，使用纤维束追踪的方法重建前联合纤维，并研究前联合白质结构连接异常与精神病性症状间的关系。结果患者组前联合平均部分各向异性分数（fractional anisotropy，FA）值（0．482±0．068）较对照组（0．537±0．053）明显下降（F=10．418，P=0．002）。患者组入组时PANSS总分为（96．3±17．7）分，其中阴性症状分量表分为（19．2±7．8）分，阳性症状分量表分为（27．0±6．5）分。患者组前联合FA值与人组时阳性因子分呈负相关（r=-0．533，P=0．013），但与PANSS总分和阴性因子分问无相关性（均P〉0．05）。结论前联合白质纤维微结构的受损可能与精神分裂症患者幻觉、妄想等阳性症状的产生机制相关。

Objective To investigate the white matter integrity of anterior commissure （ AC ）, and to explore the relationship between AC connectivity and psychotic symptoms in first-episode schizophrenia. Methods Diffusion tensor imaging, scans were conducted in 24 patients with first-episode schizophrenia and 29 healthy controls. Fiber tracking was used to reconstruct the white matter fiber connectivity of AC to examine white matter integrity. The relationship between AC integrity and psychotic symptoms was analyzed. Results Significant reduction in mean fractional anisotropy （FA） was found in patients （0. 482 ± 0. 068 ） compared with healthy controls（0. 537±0. 053, F = 10. 418 ,P =0. 002）. The PANSS total score of patient was （96. 3 ± 17.7）,with positive symptom score of （27.0 ±6. 5 ） and negative symptom score of （19. 2 ± 7. 8 ）. In addition, mean FA value of AC tracts in patients was negatively correlated with PANSS positive symptom score （r = -0. 533, P = 0. 013 ）, but no significant correlation was found between FA value and PANSS total scores or negative symptom score （ P 〉 0. 05 ）. Conclusion The deficit of AC microstructure integrity may he related to the mechanism of positive symptom in schizophrenia.