首发精神分裂症前扣带皮质谷氨酸代谢及T2信号变化的MRI研究

Study of glutamate metabolite and MRI-T2 signals in the anterior cingulate cortex in patients with first-episode schizophrenia

目的探讨首发精神分裂症(SZ)患者前扣带皮质区的谷氨酸代谢及T2信号强度变化规律及潜在联系。方法收集25例首发未用药SZ患者(研究组)和25名健康对照(对照组)。两组分别行前扣带皮层区的1H-MRS及快速自旋回波T2序列,分析SZ患者前扣带皮质区的谷氨酸代谢指标及T2信号强度的变化规律。并分析谷氨酸代谢指标与阳性和阴性综合征量表(PANSS)评分之间的相关性。结果研究组前扣带皮质NAA/Cr比值低于对照组(P<0.05),研究组前扣带皮质Glu/Cr、Glx/Cr比值高于对照组(P<0.05)。研究组前扣带皮质Glu/Cr、Glx/Cr比值与PANSS总分及阴性症状分、阳性症状分均无相关性(P>0.05)。研究组双侧前扣带皮质T2信号强度高于对照组(P<0.05)。结论前扣带皮质区谷氨酸代谢及T2信号强度的联合分析,可为SZ临床早期诊断提供新的思路,借此思路或可解释首发精神分裂症患者前扣带皮质区的谷氨酸代谢异常及病理改变两者之间的潜在联系。

Objective To investigate the changes and their potential relationship of glutamate metabolism and T 2 signal intensity in anterior cingulate cortex of patients with first episode schizophrenia (SZ). Methods 25 first-episode drug-free schizophrenics(study group) and 25 healthy subjects(control group) were selected and underwent 1H-MRS and FSE-T 2 sequencing. The glutamate metabolism index and MRI-T 2 signal intensity in anterior cingulate cortex were analyzed.And the relationship between glutamate metabolism index and Positive and Negative Syndrome Scale(PANSS) was analyzed. Results,The NAA/Cr of anterior cingulate cortex in study group was significantly lower than that in control group( P <0.05).The Glu/Cr and Glx/Cr in anterior cingulate cortex in study group were significantly higher than those in control group( P <0.05). There existed no correlations among Glu/Cr, Glx/Cr of anterior cingulate cortex and total score and factor scores of negative symptom, positive symptom of PANSS( P >0.05). The levels of T 2 signal intensity of bilateral anterior cingulate cortex in study group were significantly higher than those in control group( P <0.05).ConclusionThe combination of glutamate metabolism and T 2 signal intensity in anterior cingulate cortex of patients with first-episode schizophrenia may become a new idea in the early diagnosis of schizophrenia,and this idea may explain the causal relationship between glutamate metabolic abnormalities and pathologic changes of anterior cingulate cortex in first-episode schizophrenics.