运用基于体素的脑形态测量学法检测缺陷型及非缺陷型精神分裂症患者脑灰质结构异常  

Gray matter volume differences in deficit and nondeficit schizophrenia：a voxel-based morphometric study

作　　者：王晓晟[1] 王湘[2] 颜莉蓉[4] 谭长连[3] 司徒卫军[3] 李亚军[3] 姚树桥[2] 

机构地区：[1]中南大学湘雅医学院人体解剖学与神经生物学系,长沙410013 [2]湘雅二医院医学心理研究中心 [3]湘雅二医院医学放射科 [4]广州军区武汉总医院信息科

出　　处：《中华行为医学与脑科学杂志》2010年第7期587-590,共4页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：国家自然科学基金青年科学基金项目（30700236,30800253）;教育部高等学校博士学科点专项科研基金新教师基金项目（20070533067）

摘　　要：目的 应用基于体素的脑形态测量学（Voxel-based Morphometric,VBM）法,比较缺陷型与非缺陷型精神分裂症患者大脑灰质结构损害的差异.方法 采用GE Signa TwinSpeed 1.5T超导型MRI成像系统,对缺陷型精神分裂症（N=10）、非缺陷型精神分裂症（n=11）及正常对照（n=15）进行全脑扫描,获取脑解剖结构MR T1图像.随后基于Matlab7.6及SPM5进行优化的VBM数据分析,再进行成组t检验.结果 与正常对照相比,非缺陷型患者的额、顶、颞、枕叶及基底节均有灰质体积下降;而缺陷型患者的灰质下降以广泛及显著的额叶损伤为特征,包括左额内侧回、双侧额下回、左侧额中回及左侧眶回等多个额叶区域,另外还涉及左颞中回、右颞上回以及右侧脑岛（Cluster≥30 mm^3,P〈0.01）.两种亚型患者的比较显示,缺陷型患者在左额内侧回、双侧额下回、右中央前回以及右颞上回等脑区的灰质体积均低于非缺陷型患者（Cluster≥30 mm^3,P〈0.01）.结论 精神分裂症的结构异质性可能是在共有额叶-颞叶脑区的灰质结构改变的基础上,缺陷型与非缺陷型的患者各有其特定的灰质下降模式.Objective To examine the differences in the structure of brain white matter among deficit schizophrenia, nondeficit schizophrenia and healthy controls by using voxel-based morphometry （VBM）. Methods Ten deficit schizophrenic patients, eleven nondeficit patients and fifteen healthy comparison subjects participated in the study. All the subjects were scanned by GE Twin Speed 1.5T MRI system. Whole brain, voxel-wise analyses of regional white matter volume were conducted by the VBM toolbox on the Matlab7.6 and SPM5. t -test was then used for the comparison between groups. Results Compared to the healthy controls, nondeficit schizophrenic patients significantly decreased the density of gray matter in the frontal, parietal, temporal, occipital lobe and basal ganglia , while the deficit patients showed the characteristically broad and significant decreasion in the frontal lobe, including left medial frontal gyrus, bilateral inferior frontal gyrus, left middle frontal gyrus, and left orbital gyrus （Cluster ≥ 30 mm3, P〈0.01）. Moreover, deficit patients showed the decreasion in the temporal cortex and the limbic lobe （right insula）. Relative to the nondeficit schizophrenic patients, deficit patients had significant regional gray matter decreases in the left medial frontal gyrus, bilateral inferior frontal gyrus, right precentral gyrus, and right superior temporal gyrus （Cluster ≥ 30 mm3, P〈0.01）. Conclusion Structural heterogeneity in schizophrenia may relate to specific patterns of gray matter density reductions in deficit and nondeficit patient. However the two subtype of schizophremia patients share a common prefrontal-temperal pattern of structural brain alterations.

关 键 词：缺陷型精神分裂症 磁共振成像 基于体素的形态学分析 灰质 

分 类 号：R749.3[医药卫生—神经病学与精神病学]