精神分裂症患者急性期药物治疗前后的脑灰质变化  

Changes of cerebral gray matter pre- and post-treatment in patients with schizophrenia

作　　者：项琼[1] 王颖婵[1] 朱殿明[1] 卓恺明[1] 王征[2] 徐一峰[1] 刘登堂[1] XIANG Qiong;WANG Ying-chan;ZHU Dian-ming;ZHUO Kai-ming;WANG Zheng;XU Yi-feng;LIU Deng-tang(Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China;Institute of Neuroscience,Shanghai Institute for Biological Science, Chinese Academy of Science, Shanghai 200031, China)

机构地区：[1]上海交通大学医学院附属精神卫生中心精神病性障碍科,上海200030 [2]中国科学院神经科学研究所,上海200031

出　　处：《上海交通大学学报（医学版）》2017年第2期203-206,共4页Journal of Shanghai Jiao tong University:Medical Science

基　　金：国家自然科学基金(81371479);上海市科学技术委员会引导类项目(15411964400);上海市卫生和计划生育委员会项目(2014ZYJB0002;20134006;20144Y0054);上海市市级医院适宜技术项目(SHDC12014214);上海市精神疾病临床医学中心项目(2014);上海市精神卫生中心早期精神病性障碍科项目(2013-YJTSZK-05);上海市自然科学基金(16ZR1430500)~~

摘　　要：目的·探讨短期药物治疗对精神分裂症急性期患者大脑结构(尤其是灰质)的影响。方法·共27例未服药的早期精神分裂症患者(病程不超过5年)和21名健康志愿者入组,其中27例患者接受抗精神病药物治疗8周,分别于基线及8周后(21例精神分裂症患者及21例健康志愿者)进行3T磁共振扫描。使用基于体素的形态学分析(VBM)方法分析大脑灰质体积及其变化。结果·与健康对照组比较,精神分裂症患者的左侧小脑后叶、左侧颞中回及双侧海马旁回的灰质容积减少(P=0.000,体素>50)。8周后随访,健康对照组的灰质体积无变化。经抗精神病药物治疗8周后,精神分裂症患者较多脑区的灰质容积缩小,主要包括双侧颞上回、颞中回、颞下回,双侧额上回、额中回、额下回,双侧海马旁回及扣带回,右侧缘上回,右侧小脑后叶,右侧舌状回(P=0.000,体素>50)。结论·抗精神病药物短期治疗(8周)对急性期精神分裂症患者的大脑灰质可能产生不利影响,引起灰质体积的缩小。To observe the changes of cerebral gray matter pre- and post-treatment with short term drugs in patients with schizophrenia.Methods · T1-weighted brain MRIs were obtained on a 3T scanner in 21 controls and 27 subjects with schizophrenia who were not given antipsychotic medication. The controls and 21 schizophrenia patients received the second scan after 8 weeks of antipsychotic treatment. Voxel-based morphometry (VBM) were used to investigate the differences in gray matter (GM), mainly about the regional GM volumes. Results · GM volumes were significantly smaller in the patient group than those of healthy controls in left cerebellum posterior lobe , left and right parahippocampalgyrus, left middle temporalgyrus(P=0.000, voxels>50). GM volumes extensively decreased after 8 weeks of antipsychotic-treatment compared with pre-treatment in the superior,middle, and inferior temporal gyri, superior,middle and inferior frontal gyri, parahippocampa gyri, cingulate gyri, right supramarginal gyrus, right cerebellum posterior lobe, and right lingual gyrus(P=0.000, voxels>50). Conclusion · Short term antipsychotic treatment (8 weeks) may have adverse effects on the gray matter of patients with acute schizophrenia by reducing the volume of gray matter.

关 键 词：精神分裂症 灰质 基于体素的形态学分析 抗精神病药物 磁共振成像 

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