成年早期精神分裂症首次发病患者脑灰质体积变化的初步研究  

A preliminary study on the alterations of grey matter volume in patients with early adulthood episode schizophrenia LIU Ping-ping

作　　者：刘萍萍[1,2] 余洪军[3] 李娜[2] 罗春蓉[3] 卢瑾[2] 刘芳[2] 王继才[2] 李海军[3] 程宇琪[2] 许秀峰[2] 

机构地区：[1]南充市中心医院神经内科 [2]昆明医科大学第一附属医院精神科,650032 [3]昆明市第一人民医院磁共振室

出　　处：《中华精神科杂志》2012年第5期274-280,共7页Chinese Journal of Psychiatry

基　　金：云南省科技厅昆明医学院联合基金（2008C005R）;云南省卫生科技计划项目（2010NS016,2010NS021）

摘　　要：目的探讨成年早期（18～25岁）首次发病精神分裂症患者脑灰质体积异常区域，并寻找与精神症状相关的灰质体积局部脑区。方法对21例符合美国精神障碍诊断与统计手册第4版成年早期首次发病精神分裂症患者（患者组）和21名与之相匹配的正常对照（对照组）进行全脑磁共振扫描，获取3D脑结构图像，然后使用优化的基于体素形态学分析法进行数据分析并比较2组脑灰质体积差异；使用阳性和阴性症状量表（PANSS）进行精神症状严重程度的评定，并对患者灰质体积局部脑区与精神症状进行相关分析。结果与对照组比较，患者组左侧眶回（t=4．88，P〈0．001）、左侧额中回（t=4．50，P〈0．001）、左侧颞中回（t=3．95，P〈0．001）、右侧颞中回（t=3．92，P〈0．001）、左侧顶上小叶（t=3．71，P〈0．001）、左侧顶下小叶（t=3．93，P〈0．001）及右侧舌回／楔叶（t=3．65，P〈0．001）脑区灰质体积减少；患者组PANSS总分与右侧顶上小叶正相关，与左侧桥脑／中脑负相关；阳性症状分与右侧顶下小叶负相关；阴性症状分与有侧顶上小叶、双侧楔前叶正相关，与左侧桥脑／中脑负相关；一般精神症状分与右侧颞下回、右侧顶下小叶、左侧桥脑／中脑负相关。结论成年早期首次发病精神分裂症患者存在多个脑区灰质体积异常，且有多个脑区的灰质体积与患者精神症状严重程度相关。Objective To investigate the grey matter volume in patients with early adulthood episode （18-25 ages） schizophrenia and the correlations between regional volume and symptom severity. Methods Twenty-one schizophrenia patients with early adulthood episode and twenty-one normal controls matched with age, sex and education were recruited. The diagnosis of schizophrenia was made according to the Diagnostic and Statistical Manual of Mental Disorder the Fourth Edition （ DSM-1V ） criteria. Each participant received whole brain MRI scans, then the 3D brain structural MRI images were obtained. The grey matter volume difference between patients and controls was analyzed by using the optimized voxel- based morphometry method （VBM）. Symptom severity were assessed using the Positive and Negative Syndrome Scale （PANSS）, and the correlation with the grey matter volume were analyzed in the patients. Results Compared to the normal controls, the patients had multiple brain areas abnormal volume. It showed significant decreased grey matter volume in the left orbital gyrus （t = 4. 88 ,P 〈 0. 001 ） , left middle frontal gyrus （ t = 4. 50, P 〈 0. 001 ）, left middle teporal gyrus （ t = 3.95, P 〈 0. 001 ）, right middle temporal gyrus （ t = 3.92 ,P 〈 0. 001 ）, left superior parietal lobule（ t = 3.71 ,P 〈 0. 001 ）, left inferior parietal lobule （ t = 3.93, P 〈 0. 001 ） and right lingual gyrus/euneus （ t = 3.65, P 〈 0. 001 ）. Within the patient group, total score of PANSS was positively correlated with grey matter volume of the right superior parietal lobule, but negatively correlated with the left pons/midbrain; and the positive symptom score was negatively related to grey matter volume of the right inferior parietal lobule; and the negative symptom score was positively correlated with grey matter volume of the right superior parietal lobule, bilateral preeuneus, but negatively correlated with grey matter of the left pons/midbrain; and the common score was negatively correlated with

关 键 词：精神分裂症 磁共振成像 灰质 基于体素的形态学分析 

分 类 号：R749.3[医药卫生—神经病学与精神病学]