首发未治疗的精神分裂症患者的大脑皮质的变化  

A study of cerebral cortex in untreated first-episode schizophrenics

作　　者：郑俩荣[1] 王雁新 李盟[3] 李雷俊[1] 康庄 国效峰[4] 张晋碚[1] 赵靖平[4] 魏钦令[1] 

机构地区：[1]中山大学附属第三医院精神科,广州510630 [2]放射科 [3]华南师范大学心理系 [4]中南大学湘雅二医院精神卫生研究所 精神病学与精神卫生学湖南省重点实验室

出　　处：《中华医学杂志》2013年第41期3252-3255,共4页National Medical Journal of China

基　　金：国家自然科学基金（81270019）;2010年卫生行业科研专项（201002003）;广东省自然科学基金（S2012010009027）;广东省科技计划项目（20118031800101）

摘　　要：目的研究首发未治疗的精神分裂症患者的大脑皮质厚度和皮质表面积的变化。方法对2009年9月至2012年3月在中山大学附属第三医院精神科住院的57例首发未治疗的精神分裂症患者和同期广告招募的57名健康对照的全脑结构进行三维高分辨率磁共振成像，采用基于表面分析的方法（SBM）分析精神分裂症患者大脑皮质厚度和皮质表面积的变化，采用一般线性模型（GLM）检测两组之间的大脑皮质厚度和皮质表面积的差异，使用蒙特卡洛模拟的方法进行多重校正。结果精神分裂症患者左侧额上回、左中扣带回尾侧、左外侧枕叶、右侧额上回、右侧颞上回、右侧梭状回区的皮质厚度较健康对照分别减少6．0％、7．2％、8．2％、5．2％、7．1％、6．0％（P〈0．05）。其中左外侧枕区皮质厚度降低最明显。患者组各个脑区皮质表面积与健康对照组无统计学意义差异。结论精神分裂症患者存在多个脑区大脑皮质厚度降低，这可能是精神分裂症的神经病理机制。Objective To detect the changes of cortical thickness and cortical surface area in untreated patients of first-episode schizophrenia. Methods Fifty-seven untreated patients of first-episode schizophrenia （SCZ） hospitalized from September 2009 to March 2012 at Department of Psychiatry, Third Affiliated Hospital, SUN Yat-sen University and 57 healthy controls （HC） recruited by advertising during the same period underwent a high resolution three-dimensional magnetic resonance imaging of brain structures. And cortical-surface based technique was used to analyze the cortical thickness and cortical surface area. The general linear model （GLM） was employed to detect the differences of cortical thickness and cortical surface area between two groups. Results were corrected for multiple comparisons by the Monte Carlo simulation method. Results As compared with HC, the cortical thickness of left superior frontal, left caudal middle eingulate, left lateral occipital, right superior frontal, right superior temporal and right fusiform regions in SCZ decreased by 6.0%, 7.2%, 8.2%, 5.2%, 7.1% and 6.0% respectively. And the largest reductions ocemTed in left lateral occipital regions. Cortical surface area of each brain regions in SCZ had no significant difference with HC. Conclusion Cortical thickness reductions exist in multiple brain regions in schizophrenia. It may be the neuropathologieal mechanisms of schizophrenia.

关 键 词：精神分裂症 磁共振成像 大脑皮质 

分 类 号：R749.3[医药卫生—神经病学与精神病学]