首发与复发急性期精神分裂症患者脑白质弥散张量成像研究
Diffusion tensor imaging study of white matter in patients with first-episode and recurrent schizophrenia

摘要：目的 分析首发和复发急性期精神分裂症患者脑白质完整性的变化，探究精神分裂症的发病机制。方法 纳入34例首发、33例复发的精神分裂症患者及50例健康对照者，收集人口学资料及临床资料并进行核磁共振(弥散张量成像)扫描。采用基于脑白质骨架的空间追踪法(tract-based spatial statistics, TBSS)分析方法评估脑白质完整性。结果 与对照组相比，首发组和复发组的双侧上纵束、双侧下额枕束、双侧小脑中脚、胼胝体体部和压部及双侧前、后放射冠和左侧上放射冠FA(fractional anisotropy)值降低(P<0.05)。与复发组相比，首发组双侧上纵束、双侧前放射冠、胼胝体体部和压部的FA值明显降低；左侧下额枕束、双侧小脑中脚的FA值明显升高(P<0.05)。结论 首发和复发的急性期精神分裂症患者脑白质结构均存在广泛异常，首发患者的脑白质完整性损害更严重。
ABSTRACT: Objective To analyze brain white matter integrity of patients with schizophrenia in the first episode and recurrent episode so as to explore the pathogenesis of schizophrenia. Methods Demographic and clinical information was collected and magnetic resonance imaging was performed in 34 patients with first-episode schizophrenia, 33 patients with recurrent schizophrenia, and 50 healthy controls. The tract-based spatial statistics (TBSS) was used to evaluate the white matter integrity. Results Compared with the control group, both the schizophrenics in the first episode and recurrent episode showed decreased fractional anisotropy (FA) values in bilateral superior longitudinal tract, bilateral inferior frontal and occipital tracts, bilateral middle cerebellar peduncle, corpus callosum corpora and compressor, bilateral anterior and posterior radiating corona, and left superior radiating corona (P<0.05). Compared with those in recurrent episode, the FA values of the patients in the first episode decreased significantly in bilateral upper longitudinal tract, bilateral anterior radial crown, corpus callosum body part and compression part, but increased in left inferior frontal occipital tract and bilateral cerebellar middle foot (P<0.05). Conclusion The white matter of patients with schizophrenia in the first episode and recurrent episode shows extensive abnormalities, and the damage of white matter integrity is more serious in patients with first-episode schizophrenia