首发精神分裂症患者的前联合白质完整性对认知功能的影响  

The role of the white matter integrity of the anterior commissure in cognitive functions in first-episode schizophrenia

作　　者：赵可[1] 王强[1] 邓伟[1] 李名立[1] 韩媛媛[1] 林鄞[2] 丁蕾[1] 李寅飞[1] 李涛[1] 

机构地区：[1]四川大学华西医院心理卫生中心精神医学研究室,人类疾病生物治疗国家重点实验室,成都610041 [2]广州市脑科医院

出　　处：《中国神经精神疾病杂志》2014年第1期16-20,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：国家自然科学基金(编号:30971056;81130024;81171275);科技部十二五支撑计划(编号:2011BAZ02530);教育部博士点基金(编号:20110181110014;20110181120033)

摘　　要：目的研究首发精神分裂症患者前联合白质纤维完整性与精神分裂症的关系及其对认知功能的影响。方法对24例首发精神分裂症患者和29名正常对照者行弥散张量成像(diffusion tensor imaging,DTI)扫描,使用纤维束追踪的方法重建前联合纤维,并研究前联合纤维连接异常与认知功能间的关系。结果患者组前联合平均部分各向异性(fractional anisotropy,FA)值较对照组下降[(0.48±0.07)vs.(0.54±0.05),P=0.002],连线测验(trail making test,TMT)完成时间延长[TMT_A:(55.19±19.15)vs.(36.61±11.72),P<0.001;TMT_B:(88.84±38.92)vs.(53.75±23.41),P<0.001],逻辑记忆测试分数低于对照组[即刻逻辑记忆分数:(6.12±3.85)vs.(11.69±3.68),P<0.001;延时逻辑记忆:(3.33±3.16)vs.(9.83±4.15),P<0.001]。且患者组的FA值与TMT_A测验时间(r=-0.458,P=0.037)和TMT_B测验时间(r=-0.541,P=0.011)分别呈负相关,但在对照组未发现此相关性。结论本研究支持精神分裂症的脑功能连接异常假说,前联合白质纤维微结构受损可能是精神分裂症患者执行功能受损的原因之一,提示白质纤维完整性是精神分裂症的一个重要内表型。Objective To investigate the relationship between the white matter fiber connectivity of the anterior commissure （AC） and schizophrenia, and to explore the role of AC connectivity in cognitive functions in first-episode schizophrenia. Methods Twenty-four patients with first-episode schizophrenia and 29 healthy controls underwent diffu- sion tensor imaging （DTI） to measure fractional anisotropy （FA）. Fiber tracking was then used to reconstruct the white matter fiber connectivity of AC to examine the white matter integrity. We also analyzed the relationship between AC integ-rity and cognitive function. Results Compared to healthy controls, patients with first-episode schizophrenia had a signifi- cant reduction in mean FA of AC tracts [（0.48±0.07） vs. （0.54±0.05）, P=0.002], longer completion time in trail making test （TMT） [TMT_A： （55.19± 19.15） vs. （36.61 ± 11.72）, P〈0.001; TMT_B： （88.84± 38.92） vs. （53.75 ± 23.41）, P〈0.001] and worse performance in logical memory test [immediate logical memory score： （6.12±3.85） vs. （11.69±3.68）, P〈0.001; delay logical memory score： （3.33±3.16） vs. （9.83±4.15）, P〈0.001]. In addition, there was negatively correlation of mean FA of AC tracts with TMT_A completion time （r=-0.458, P=0.037） or TMT_B completion time （r=-0.541, P=0.011） inpatients with schizophrenia, but not in controls. Conclusion This study supports the disconnection hypothesis of schizo- phrenia. The deficit of AC microstructure integrity may be partly responsible for impaired executive functions in schizo-phrenia, suggesting that the integrity of white matter fiber is an important endophenotype of schizophrenia.

关 键 词：前联合 精神分裂症 认知障碍 弥散张量纤维束成像 

分 类 号：R749.3[医药卫生—神经病学与精神病学]