精神分裂症伴迟发性运动障碍患者脑铁沉积研究  

A cross-sectional study of brain iron deposition in schizophrenia with tardive dyskinesia

作　　者：徐乐平[1] 潘园园[1] 汪莉[1] 宋梓祥[1] 纪菊英[1] 陈琪[1] 周菲菲[1] 孙剑[1] 赵汉清[1] 

机构地区：[1]解放军第一0二医院精神科,常州213003

出　　处：《中华精神科杂志》2013年第2期90-93,共4页Chinese Journal of Psychiatry

摘　　要：目的探讨伴与不伴迟发性运动障碍（TD）的精神分裂症患者及正常健康人脑铁沉积与TD的关系。方法采用磁敏感加权成像技术，测定TD患者（TD组，14名）、非TD患者（非TD组，14例）和正常健康人（对照组，14名）黑质、尾状核等基底节灰质核团的校正相位值（CP）；采用异常不自主运动量表（AIMS）评定TD症状。结果（1）调整年龄、性别因素后，TD组黑质、尾状核CP值分别为（-0．207±0．029）、（-0．097±0．021）tad，非TD组分别为（-0．166±0．031）、（-0．075±0．014）tad，对照组分别为（-0．142±0．033）、（-0．081±0．017）tad；TD组低于非TD组（d=0．041，0．022；P=0．001，0．001）和对照组（d=0．064，0．015；P=0．000，0．027）；非TD组黑质CP值低于对照组（d=0．024，P=0．043），差异均有统计学意义。（2）TD组尾状核CP值与AIMS严重程度评分负相关（r5=-0．508，P=0．025）；Logistic回归分析显示，黑质、尾状核CP值低（B=-76．869，P=0．026；p=-185．876，P：0．042）、年龄高（p=0．388，P=0．055）与TD的发生有关。结论TD患者基底节存在过量脑铁沉积，并与TD发生可能存在-定的联系。Objective To investigate the difference of brain iron deposition among schizophrenia with or without tardive dyskinesia （TD）, and healthy volunteers, so as to explore its relationship with pathogenesis of TD. Methods Susceptibility weighted imaging MRI findings were studied in 14 schizophrenic patients with TD, 14 schizophrenic patients without TD, and 14 healthy controls. The corrected phase （ CP ） of basal ganglia including substantia nigra （ SN ） , caudate nucleus （ CN ） were measured. The Abnormal Involuntary Movement Scale （AIMS） was used for evaluating the clinical status of TD. Results After adjusting for age, sex, the mean CP of SN and CN were significantly decreased in TD patients [ （ - 0. 207 ± 0. 029 ）, （ - 0. 097 ± 0. 021 ） tad ] compared to non-TD patients [ （ - 0. 166 ±0. 031 ）, （ -0. 075 ± 0. 014） tad; d = 0. 041,0. 022; both P -- 0. 001 ] and healthy subjects [ （ - 0. 142 ＋ 0. 033 ）, （ - 0. 081 ± 0. 017） rad ;d = 0. 064,0. 015 ; P = 0. 000,0. 027 ] , while the mean CP of SN was significantly lower in non-TD patients than that in healthy subjects（d =0. 024, P =0. 043）. Decreased mean CP of CN correlated with higher severity score of AIMS in TD patients（ r5 = - 0. 508 ,P = 0. 025 ）. Logistic regression analysis showed that the decreased CP value in SN （ [3 = -76. 869 ,P --0. 026） and CN（ B = - 185. 876 ,P = 0. 042） , aging （ B = 0. 388, P = 0. 055 ） were associated with the onset of TD. Conclusions The results indicate the increase in iron accumulation in basal ganglia may be associated with pathogenesis of TD in schizophrenic patients.

关 键 词：运动障碍 药物性 精神分裂症 铁 磁共振成像 

分 类 号：R749.3[医药卫生—神经病学与精神病学]