双相情感障碍与精神分裂症之间脑白质微结构的差异研究  

A comparative study of white matter integrity in bipolar affective disorder and schizophrenia

作　　者：周一婷 李名立[1] 余华[1] 李寅飞[1] 李涛 ZHOU Yiting;LI Mingli;YU Hua;LI Yinfei;LI Tao(Mental Health Center,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China;Department of Neurobiology,Affiliated Mental Health Center&Hangzhou Seventh People’s Hospital,Zhejiang University School of Medicine,Hangzhou,Zhejiang 310013,P.R.China)

机构地区：[1]四川大学华西医院心理卫生中心,成都610041 [2]浙江大学医学院附属精神卫生中心杭州市第七人民医院,杭州310013

出　　处：《华西医学》2022年第12期1805-1811,共7页West China Medical Journal

基　　金：国家自然科学基金(81630030,82071524);四川省科学技术厅科技计划项目(2021YJ0238)。

摘　　要：目的使用弥散张量成像(diffusion tensor imaging,DTI)探索双相情感障碍和精神分裂症这两种疾病大脑白质改变的共性与特性。方法选择2014年10月—2017年1月在四川大学华西医院心理卫生中心就诊的精神分裂症及双相情感障碍患者。并于2014年10月—2017年1月招募正常对照人群志愿者。将纳入患者根据诊断分为精神分裂症组和双相情感障碍组。将志愿者分为正常对照组。并将双相情感障碍组分为躁狂发作与抑郁发作2个亚组。对纳入患者与志愿者进行DTI扫描。使用基于白质骨架的纤维束空间统计分析(tract based spatial statistics,TBSS)研究患者及正常对照人群之间的白质部分各向异性(fractional anisotropy,FA)差异,并对双相情感障碍2个亚组和精神分裂症组的FA值进行比较。结果本研究共纳入患者99例,正常对照组40例。其中,精神分裂症组40例,双相情感障碍组59例(躁狂发作31例、抑郁发作28例)。与正常对照组比较,双相情感障碍组及精神分裂症组均在胼胝体体部、穹隆、枕钳及左侧下纵束出现FA值降低(P<0.05)。双相情感障碍组与精神分裂症组之间的FA值比较差异均无统计学意义(P>0.05),但双相情感障碍抑郁发作亚组与精神分裂症组比较,存在左侧丘脑后辐射的FA值下降(P=0.001)。结论双相情感障碍和精神分裂症的白质改变存在共性,但丘脑后辐射的白质变化或为双相情感障碍抑郁发作的特征性改变。Objective To explore the difference of white matter changes between bipolar affective disorder and schizophrenia using diffusion tensor imaging(DTI).Methods Patients with bipolar affective disorder and schizophrenia were selected from the Mental Health Center of West China Hospital of Sichuan University between October 2014 and January 2017.Volunteers were recruited from October 2014 to January 2017.The included patients were divided into bipolar affective disorder group and schizophrenia group according to their diagnosis.Volunteers were divided into normal control group.The bipolar affective disorder group was divided into two subgroups:manic episode and depressive episode.DTI was performed on the included patients and volunteers.Tract based spatial statistics(TBSS)was used to study the differences in fractional anisotropy(FA)of white matter between patients and normal controls,and FA values of two subgroups of bipolar affective disorder and schizophrenia were compared.Results A total of 99 patients and 40 normal controls were included in this study.Among them,there were 40 cases in schizophrenia group and 59 cases in bipolar affective disorder group(31 cases of manic episode and 28 cases of depressive episode).Compared with the normal control group,FA values decreased in corpus callosum,fornix,occipital forceps and left inferior longitudinal fasciculus with bipolar affective disorder group and schizophrenia group(P<0.05).There was no significant difference in FA values between bipolar affective disorder group and schizophrenia group(P>0.05),but the FA value in left posterior thalamic radiation decreased in depressive episode of bipolar affective disorder group compared with schizophrenia group(P=0.001).Conclusions There are similarities between white matter changes in bipolar affective disorder and schizophrenia.However,the white matter change in posterior thalamic radiation may be the characteristic change in depressive episode of bipolar affective disorder.

关 键 词：精神分裂症 双相情感障碍 弥散张量成像 白质 

分 类 号：R749.4[医药卫生—神经病学与精神病学] R749.3[医药卫生—临床医学]