首发儿童少年精神分裂症患者幻听与脑白质体积关系研究  

The relationship between auditory verbal hallucinations and white matter volume in first-episode childhood and adolescence-onset schizophrenia

作　　者：李亚迪 张慧 李玉玲[1] 梁颖慧[1] 夏艳红[1] 郭敬华[1] 郭素芹[2] LI Yadi;ZHANG Hui;LI Yuling;LIANG Yinghui;XIA Yanhong;GUO Jinghua;GUO Suqin(Department of Child and Adolescent Psychiatry,the Second Affiliated Hospital of Xinxiang Medical University,Henan Key Lab of Biological Psychiatry of Xinxiang Medical University,International Joint Research Laboratory for Psychiatry and Neuroscience of Henan,Xinxiang 453002,China)

机构地区：[1]新乡医学院第二附属医院儿童少年精神科,新乡453002 [2]新乡医学院第二附属医院儿童少年精神科,河南省生物精神病学重点实验室,河南省精神神经医学国际联合实验室 [3]驻马店市第二人民医院临床心理科

出　　处：《中国神经精神疾病杂志》2021年第3期134-140,共7页Chinese Journal of Nervous and Mental Diseases

基　　金：河南省重点科技攻关计划项目(编号:132102310446);河南省科技发展计划项目(编号:182102310155)。

摘　　要：目的探讨首发儿童少年精神分裂症患者脑白质结构特点,分析幻听严重程度与白质体积之间的关系。方法纳入78例首发儿童少年精神分裂症患者(患者组)与35名健康儿童少年(对照组)。根据阳性症状量表(positive symptoms scale,SAPS)中听幻觉评分将患者分为无幻听组21例,轻中度幻听组35例,重度幻听组22例。用阳性与阴性症状量表(positive and negative syndrome scale,PANSS)评估所有患者的精神症状。采集所有研究对象的静息态MRI数据,使用基于体素形态学方法(voxel based morphometry,VBM)分析全脑白质体积值。结果患者组较对照组白质体积减少的脑区位于左侧小脑前叶、左侧颞上叶、左侧扣带回、胼胝体、左侧额中叶(P<0.05,AlphaSim校正)。三组患者之间白质体积存在差异的脑区位于左侧颞上叶、右侧颞上叶、左侧额中叶(P<0.05,AlphaSim校正)。与无幻听组比较,轻中度幻听组左侧颞上叶白质体积减少(P<0.05,AlphaSim校正);与无幻听组及轻中度幻听组比较,重度幻听组左侧颞上叶白质体积均增加(P<0.05,AlphaSim校正)。相关分析显示,患者组左侧小脑前叶白质体积与PANSS阳性症状分呈负相关(r=-0.34,P<0.01),左侧颞上叶白质体积与PANSS阴性症状分呈负相关(r=-0.24,P=0.04),右侧颞上叶白质体积与SAPS幻听评分呈正相关(r=0.26,P=0.02)。结论首发儿童少年精神分裂症患者存在多个脑区白质体积减少,幻听的严重程度与颞叶白质体积相关,幻听发生的神经影像机制可能与颞叶白质体积异常有关。Objective To explore the brain structural characteristics of white matter in first-episode childhood and adolescence-onset schizophrenia(CAOS)and analyze the relationship between the severity levels of auditory hallucinations and white matter volumes(WMV).Methods Seventy-eight cases of first-episode CAOS patients(case group)and 35 healthy controls(HCs)were recruited in the study.The CAOS patients were divided into three groups according to the auditory verbal hallucinations(AVH)assessment of positive symptoms scale(SAPS).The non-AVH group comprised 21 cases with no/suspicious auditory verbal hallucination symptoms,the mild-to-moderate AVH group consisted of 35 cases with mild and moderate auditory verbal hallucination symptoms,and the severe-AVH group involved 22 cases with severe auditory verbal hallucination symptoms.The severity of psychiatric symptoms in all patients was evaluated using the Positive and Negative Syndrome Scale(PANSS).All subjects underwent the resting-state magnetic resonance imaging(MRI).The whole brain WMV was analyzed using VBM technique.Results Compared with the HCs,the decreased WMV of patients was mainly located in the left anterior cerebellar lobe,left superior temporal lobe,left cingulate gyrus,corpus callosum,and left middle frontal lobe(P<0.05,AlphaSim correction).There were significant differences in the white matter volumetric deficits in the left superior temporal lobe,right superior temporal lobe and left middle frontal lobe among the three groups of patients(P<0.05,AlphaSim correction).Moreover,the mild-to-moderate AVH group showed decreased WMV in the left superior temporal lobe compared with the non-AVH group,while the severe-AVH group exhibited increased WMV in the left superior temporal lobe compared with the above two groups(P<0.05,AlphaSim correction).Furthermore,The WMV in the left anterior cerebellar lobe was negatively correlated with the positive symptom score(r=-0.34,P<0.01),and the WMV in the left superior temporal lobe was negatively correlated with the negative sy

关 键 词：精神分裂症 儿童少年 磁共振成像 白质 幻听 

分 类 号：R749.3[医药卫生—神经病学与精神病学]