摘要
目的:研究首发精神分裂症 (SCZ) 患者全脑白质微观结构的改变.方法:对39例首发SCZ患者 (患者组) 及39名健康志愿者 (对照组) 行头颅扩散张量成像 (DTI) 扫描.采用基于纤维束示踪的空间统计分析 (TBSS) 方法比较两组间DTI参数差异, 包括各向异性分数 (FA) 、轴向扩散系数 (AD) 、径向扩散系数 (RD) 及平均扩散率 (MD) .通过无阈值簇群增强校正 (TFCE) 方法对统计结果进行多重校正比较.提取患者组有差异脑区的FA/AD/RD/MD值同阳性与阴性症状量表 (PANSS) 各评分做Pearson相关分析.结果:与正常对照组相比, 首发SCZ患者存在多个脑区的FA值增大及AD、RD、MD值减小 (P<0.05, TFCE校正), 主要包括右侧矢状层、丘脑后辐射, 双侧大脑脚、右侧内外囊、胼胝体、右上纵束、右上放射冠等.穹窿MD值与一般精神病理学评分呈正相关 (r=0.36, P=0.02);胼胝体干RD值与一般精神病理学评分、PANSS总分呈正相关 (r=0.34, P=0.03;r=0.56, P<0.001);胼胝体压部RD值与PANSS总分呈正相关 (r=0.30, P=0.04) .结论:首发SCZ患者可能存在更为广泛的脑白质髓鞘异常和 (或) 轴突损伤.
Abstract
Objective: To examine the white-matter (WM) microstructural changes in first-episode schizophrenia patients.Methods: Diffusion tensor imaging (DTI) scan was performed for 39 first - episode schizophrenia patients and 39 healthy controls. Tract-based spatial statistics (TBSS) were adopted to examine the between - group differences in DTI measures including fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD), and mean diffusivity (MD). Multiple comparisons were cor-rected using the threshold-free cluster enhancement (TFCE) method. FA, AD, RD, and MD values of the white matter tracts which showed abnormal morphological differences were extracted, averaged and correlated with the Positive and Negative Syndrome Scale (PANSS) value in patients group.Results: Compared with the healthy control group, first-episode Schizophrenia group showed increasedFA and decreased AD, RD, MD mainly in right sagittal stratum, right posterior thalamic radiate, bi-lateral cerebral peduncle, right internal and external capsule, corpus callosum, right superior longitudi-nal fasciculus and right superior corona radiate (P<0.05, TFCE correction). Pearson correlation anal-ysis showed MD values of the fornix was positively correlated with the general psychopathology scores (r=0.36, P=0.02), RD value of the body of corpus callosum was positively correlated with the general psychopathology scores and PANSS scores (r=0.34, P=0.03; r=0.56, P<0.001), and RD value of the splenium of corpus callosum was positively correlated with PANSS scores (r=0.30, P=0.04).Conclusion: Patients with first-episode schizophrenia may have a broader range of white matter myelin abnormalities and (or) axonal injuries.
基金项目
国家自然科学基金(81601474)
陕西省重点研发计划(2017ZDXM-SF-048)
NETL
NSTL
维普
万方数据