青少年精神分裂症首次发病患者脑灰质体积与认知功能的相关性

The correlations between brain gray matter volume and cognitive function in first-episode adolescents with schizophrenia

目的:探讨首发青少年精神分裂症患者脑灰质体积与认知功能的关系。方法:33例首发青少年精神分裂症患者(患者组)和28名性别、年龄、右利手、受教育程度与之相匹配的正常对照组进行神经心理测评,包括连线测验、符号编码、词语流畅性测验、霍普金斯词语学习测验-修订版(HVLT-R)、简易视觉记忆测验-修订版(BVMT-R)、Stroop色词测验(ST-1、ST-2、ST-3)及迷宫测验和结构磁共振扫描(s MRI);用基于体素的形态学方法(VBM))分析比较两组脑灰质体积。结果:患者组除连线测验成绩显著高于正常对照组外(t=2.08,P<0.05),符号编码(t=-4.36)、HVLT-R(t=-3.74)、BVMT-R(t=-4.83)、ST-1、ST-2、ST-3(t=-3.08,t=-3.85,t=-3.62)及迷宫测验(t=-3.14)成绩明显低于正常对照组(P<0.01或P<0.001)。患者组右侧颞上回及右侧颞中回脑灰质体积较正常对照组明显减小(t=-3.868,t=3.964;P均<0.001)。Pearson相关分析显示,患者组符号编码(r=0.373,P=0.032)及迷宫测验评分(r=0.356,P=0.042)与右侧颞中回脑灰质体积正相关。结论:首发青少年精神分裂症患者存在脑灰质体积异常;这可能与认知功能广泛损害相关。

Objective：To investigate the relationship between brain gray matter volume and cognitive function in the first-episode adolescent schizophrenia. Method：Thirty-three first-episode adolescent schizo-phrenia patients（ patient group）and twenty-eight gender,age,right-handed,education level matched normal control group were recruited,and neuropsychological tests including trail marking test,symbol coding,verbal fluency test,Hopkins verbal learning test-revised（HVLT-R）,brief visuospatial menmory test-revised（BVMT-R）,Stroop color word test（ST-1,ST-2,ST-3）,maze test and structural magnetic resonance imaging（s-MRI） were conducted. The gray matter volume in two groups was andyzed and compared by the voxel-based morphom-etry（VBM）. Results：Trail marking tests in the patient group were higher than those of the control group（t =2. 08,P 〈 0. 05）,symbol coding（t = - 4. 36）,HVLT-R（t = - 3. 74）,BVMT-R（t = - 4. 83）,ST-1,ST-2,ST-3 （t = - 3. 08,t = - 3. 85,t = - 3. 62）and maze test（t = - 3. 14）were lower than the control group（P 〈 0. 01 or P 〈 0. 001）. Compared with the control group,the patients showed decrease in the right superior temporal gyrus and right middle temporal gyrus（t = - 3. 868,t = 3. 964,all P 〈 0. 001）. Pearson correlation analysis indicated symbol coding（r = 0. 373,P = 0. 032）and maze test quiz scores（r = 0. 356,P = 0. 042）showed positive corre-lation with the right middle temporal gyrus gray matter volume in the patient group. Conclusion：The first-epi-sode adolescent schizophrenia patients present the abnormalities of brain gray matter volume,and this may be re-lated to the widespread impairment of cognitive function.