首次发病未治疗精神分裂症患者大脑皮质复杂度改变

Abnormal cortical complexity of first-episode treatment-na?ve schizophrenia patients

目的探讨首次发病未治疗精神分裂症患者大脑皮质复杂度的异常特征及其与临床症状的相关性。方法使用Philip 3.0 T磁共振成像系统采集77例首次发病未治疗精神分裂症患者(患者组)及84名健康对照者(对照组)的高分辨率3D脑结构图像,采用基于SPM12的计算解剖学工具包计算分形维度(fractal dimension,FD)值表征皮质形态复杂度,2组间FD值比较采用t检验;采用偏相关分析对患者组FD值与临床症状严重程度进行相关分析。结果与对照组相比,患者组左侧上额叶皮质复杂度下降(MNI:x=-5,y=22,z=58,体素水平P<0.001,簇水平经family-wise error校正后P<0.05)。女性患者左侧上额叶皮质复杂度与PANSS总分(r=-0.357,P=0.028)、阴性症状分(r=-0.373,P=0.021)呈负相关,男性患者皮质复杂度与临床特征均无相关性。结论首次发病未治疗精神分裂症患者左侧上额叶皮质复杂度下降,女性患者阴性症状与皮质复杂度下降相关,提示精神分裂症存在早期神经发育异常,进一步支持精神分裂症的神经发育假说。

Objective To investigate abnormal cortical complexity in first-episode treatment-na?ve schizophrenia(FES)and its correlation with clinical symptom.Methods Structural brain images of 77 FES patients and 84 health controls were acquired with Philip 3.0 T MRI.Fractal dimension(FD)was calculated as a proxy of cortical complexity by Computational Anatomy toolbox in SPM12.Partial correlation analysis was conducted to explore relationship between cortical complexity and clinical symptoms.Results FD of left superior frontal lobe(SFL)decreased statistically significantly in FES patients(MNI:x=-5,x=22,z=58;voxel-level P<0.001,cluster-level family-wise error P<0.05).FD of left SFL was negatively correlated with PANSS total score(r=-0.357,P=0.028)and negative symptom score of PANSS(r=-0.373,P=0.021)in female patients but not male patients.Conclusions Cortical complexity of left SFL decreased in FES patients and correlated with negative symptoms in female,which suggested that there is early abnormal neural development in schizophrenia.