精神分裂症患者攻击行为的结构磁共振研究

A structural MRI study on aggressive behavior in patients with schizophrenia

目的运用结构磁共振方法研究伴有攻击行为的精神分裂症(schizophrenia,SZ)患者脑灰质结构特点,并探索其攻击行为与脑灰质结构的关系。方法收集伴有攻击行为的精神分裂症患者18例(SZ1组),以及性别、年龄与之相匹配的不伴有攻击行为精神分裂症患者18例(SZ2组)和正常对照18名。采用Buss和Perry攻击问卷(Buss&Perry aggression questionnaire,B&P)中文版评估患者的攻击行为,采用3.0 T磁共振对被试进行脑结构扫描,应用基于体素的形态学测量方法对影像数据进行分析处理。结果与对照组相比,精神分裂症患者脑灰质体积改变的区域主要位于双侧的额叶、颞叶和枕叶(P<0.05,Alpha Sim校正);与SZ2组相比,SZ1组灰质体积增加的脑区主要位于右侧的缘上回、中央后回、双侧的岛叶、眶额回(P<0.05,Alpha Sim校正)。精神分裂症患者的B&P评分与其右侧岛叶、中央后回、缘上回等脑区的灰质体积呈正关联(P<0.01,Alpha Sim校正)。结论精神分裂症患者的攻击行为与脑灰质体积改变存在关联,中央后回、岛叶和缘上回等脑区可能参与精神分裂症患者攻击行为的神经机制。

Objective To explore the gray matter changes in aggressive patients with schizophrenia, and the re- lationship between the gray matter and aggression in patients. Methods Eighteen aggressive patients with schizophre- nia （SZ1）, 18 age- and gender-matched un-aggressive patients with schizophrenia （SZ2） and 18 normal controls （NC） were enrolled in the study. Then a 3.0 T magnetic resonance imaging （MRI） scan was conducted for each participant. The voxel-based morphometry （VBM） approach and the Chinese version of Buss ＆ Perry aggression questionnaire （B＆P） were used to explore imaging data and to assess the aggression, respectively. Results Compared with NC, pa- tients with schizophrenia showed changes in gray matter volume （GMV） in the frontal, temporal and the occipital lobes （P〈0.05, AlphaSim corrected）. Compared with SZ2, SZ1 showed increased GMV in the right supramarginal gyrus, right postcentral gyrus, bilateral insula and orbito-frontal gyri （P〈0.05, AlphaSim corrected）. The GMV of the right insula, right postcentral gyrus and right supramarginal gyrus were positively associated with B＆P scores in patients with schizophrenia （P〈0.01, AlphaSim corrected）, respectively. Conclusions These preliminary findings support that the ag- gression in schizophrenia is associated with GMV changes of brain regions in patients with schizophrenia. The right postcentral gyrus, the right insula and the right supramarginal gyrus may be involved in the neural mechanism of ag-gression in schizophrenia.