精神分裂症患者脑结构异常的MRI研究

Structural brain abnormalities in patients with schizophrenia: a MRI study.

目的 探讨脑结构的改变 (尤其是第Ⅲ脑室 )特点及其与精神分裂症症状产生及疗效的关系。方法 选用我院住院的首发精神分裂症患者 ,共 51例 ,正常对照组为 2 3例健康志愿者。对入组后的患者于治疗前和治疗后 2个月进行PANSS(阳性与阴性症状量表 )评定 ,以PANSS减分率作为疗效指标。磁共振成像扫描采用SiemensMagnetomP8型永磁性磁共振机 ,磁场强度 0 2T。测量包括第Ⅲ脑室横径等在内的 1 7条径线。结果 病例组第Ⅲ脑室横径、双侧外侧裂宽度明显增宽 ,胼胝体厚度明显减少 ,病例组与对照组之间存在显著差异。PANSS阴性分量表、思维解体因子减分率与左侧海马横径均呈负相关。PANSS其他分量表及因子减分率与MRI各参数均无显著相关。结论 精神分裂症患者存在的脑结构异常可能构成了精神分裂症的神经生物学基础。

Objective Widespread brain abnormalities are recognized as characteristic of schizophrenia. Ventricular enlargement is found in the majority of controlled neuroimaging studies in schizophrenia. This study aims to explore the structural brain abnormalities especially third ventricular enlargement in schizophrenia and their clinical significance. Methods Quantitative MRI methods were used to address the regional specificity of structural brain abnormalities in 51 first episode patients(mean age, 28 02 years) from Nanjing Brain Hospital with CCMD 2 R schizophrenia relative to 23 healthy control subjects(mean age, 35 43 years). All patients were assessed with PANSS scale at baseline and after 2 months of treatment. Treatment response was evaluated according to the decrease of PANSS scores. Results Relative to healthy control subjects, the patients group had third ventricular enlargement(0 475±0 162 vs. 0 274±0 096, P <0 01), smaller temporal lobe(left and right, P <0 01) and decreased depth of corpus callosum(0 688±0 171 vs. 0 770±0 102, P <0 05). No general correlation was found among structural brain abnormalities and clinical efficacy. Conclusions These findings support the view that schizophrenia may involve disturbance of neurodevelopmental processes in some patients. However, the correlation between structural brain abnormalities and clinical efficacy remains uncertain