精神分裂症白质损害与发病年龄的弥散张量成像研究  

Disrupted white matter integrity is associated with earlier onset age in schizophrenia:A diffusion tensor imaging study

作　　者：蔡丽伟[1] 田霖[1] 刘琦[1] 闫俊[1] 孙伟[1] 卢天兰[1] 阮燕燕[1] 王力芳[1] 岳伟华[1] 赵强[2] 袁慧书[2] 张岱[1] 阎浩[1] 

机构地区：[1]北京大学精神卫生研究所,卫生部精神卫生学重点实验室(北京大学),北京100191 [2]北京大学第三医院放射科,北京100191

出　　处：《中国心理卫生杂志》2012年第7期483-489,I0001,共8页Chinese Mental Health Journal

基　　金：国家自然科学基金(81071088;81000580);科技部国际科技合作计划(2010DFB30820)

摘　　要：目的:应用弥散张量成像(DTI)比较精神分裂症患者脑白质与正常人群间的差异,并探究各向异性比值(FA)的改变与发病年龄之间的相关性。方法:纳入27例精神分裂症患者和29名性别、年龄及受教育程度相匹配的健康对照。两组研究对象均接受头颅磁共振检测。患者组按照发病年龄分为早发组(发病年龄<18岁)和成年发病组(发病年龄≥18岁)。采用基于体素的分析方法,分别比较患者组和对照组、早发组和成年发病组之间FA值的差异,并在控制性别、病程和药物剂量影响的前提下,分析FA值与患者发病年龄的相关性。结果:与健康对照比较,患者组在右侧上纵束、右侧放射冠上部的FA值降低;患者组中早发组和成年发病组间FA值的差异无显著性。患者组FA值与发病年龄呈正相关的脑区包括右侧放射冠前部(r=0.70,P<0.01)、右侧胼胝体膝部(r=0.65,P<0.01);未发现呈负相关的脑区。结论:本研究提示精神分裂症患者右侧脑区上纵束及放射冠部位存在白质损害,发病年龄愈早,右侧放射冠及胼胝体膝部白质纤维的受损愈重。这对精神分裂症病理生理改变及脑结构异常的进一步研究具有提示作用。Objective： To investigate the abnormal changes in white matter in patients with schizophrenia, and to explore the correlations between the fractional anisotropy （FA） alterations and the onset ge. Methods： Twenty- seven patients with schizophrenia and 29 gender, age and education matched healthy voluntc.ers underwent a diffu- sion tensor imaging （DTI） scan. According to the onset age of schizophrenia, the patients group were divided into early onset schizophrenia （EOS, 〈 18 years old） and adult onset schizophrenia （AOS, /〉 18 years old）. Voxel-based analysis of FA value was performed to investigate the difference of white matter integrity bel：ween patients and con-trois and between EOS patients and AOS patients as well. In addition, the association between FA value and the on- set age of schizophrenic patients was assessed. Results： Compared with the healthy controls, the FA values were significantly decreased in right superior longitudinal fasciculus and right superior corona radiate in schizophrenic pa- tients. Though no significant difference of FA value was found between EOS and AOS, the significantly positive correlation was found between onset age and FA values in fight anterior corona radiate and right genu of corpus cal- losum （r = 0. 70, 0. 65; Ps 〈 0.01 ）. Conclusion： It indicates that the white matter abnormalities exist in the right superior longitudinal fasciculus and right superior corona radiate in patients with schizophrenia. The schizophrenic patients with earlier onset age show more severe deficit in white matter integrity in the right anterior corona radiate and fight genu of corpus callosum. This study demonstrated that brain white matter abnormalities in schizophrenia may depend on developmental stage at onset time of the illness. The findings moreover support clues for the future studies on pathophysiological abnormalities in schizophrenia.

关 键 词：精神分裂症 白质 弥散张量 各向异性 发病年龄 

分 类 号：R749.3[医药卫生—神经病学与精神病学] R742.802[医药卫生—临床医学]