【摘要】 目的:比较阴性和阳性症状为主型精神分裂症患者前额叶和丘脑质子波谱及其与临床症状、执行功能的相关性方法:对61例阴性症状为主型精神分裂症患者(阴性组)和53例阳性症状为主型精神分裂症患者(阳性组),在入组时应用抗精神病药治疗前与治疗后8周末,采用多体素磁共振质子波谱(1H-MRS)检测前额叶和丘脑N-乙酰基天门冬氨酸(NAA)与肌酸复合物(Cr),计算NAA/Cr值;采用阳性和阴性症状量表(PANSS)和威斯康星卡片分类测验(WCST)评定临床症状和执行功能;进行两组1H-MRS、PANSS、WCST的比较与相关分析。结果:治疗前阴性组右侧丘脑NAA/Cr值(1.43±0.33)低于阳性组(1.58±0.35),(t=2.35,P<0.05);治疗前阴性组分类数(1.68±0.54)低于阳性组(2.06±0.66),(t=3.38,P<0.01),持续错误数(43.3±11.2)高于阳性组(31.8±9.22),(t=5.95,P<0.01);治疗前阴性组左侧前额叶NAA/Cr值与阴性症状分、持续错误数呈负相关(r=-0.35,P<0.05);(r=-0.36,P<0.01)。治疗前后阴性组左侧前额叶NAA/Cr值变化与阴性症状分变化、持续错误数变化呈负相关(r=-0.30,P<0.05);(r=-0.29,P<0.05),与分类数变化呈正相关(r=0.31,P<0.05)。结论:不同亚型精神分裂症患者可能存在不同的神经生物学基础,阴性症状为主型精神分裂症患者左侧前额叶神经元的损害可能是引起阴性症状、执行功能障碍的生物学基础。更多还原

【Abstract】 Objective:To compare the metabolic measures on prefrontal lobe and thalamus in negative subtype and positive subtype schizophrenics by proton magnetic resonance spectroscopy(1H-MRS),and to explore the relationship among metabolic measures,clinial symptom,and executive functioning.Method:61 negative subtype and 53 positive subtype schizophrenics were examined at prefrontal lobe and thalamus by multi-voxel 1H-MRS before antipsychotic treatment and at the end of 8-weeks’ treatment.The N-acetylaspartate(NAA) and Creatine compounds(Cr) were measured and the ratios of NAA/Cr were determined.Meanwhile,positive and negative syndrome scale(PANSS) and Wisconsin card sorting test(WCST) were also assessed.Results:In negative subtype patients,the NAA/Cr ratio on right thalamus and the categories completed pre-treatment demonstrated lower than those in positive subtype(1.43±0.33) vs(1.58±0.35),(t=2.35,P<0.05);(1.68±0.54) vs(2.06±0.66),(t=3.38,P<0.01),respectively,and the perseverative errors were higher than that in positive subtype(43.3±11.2) vs(31.8±9.22),(t=5.95,P<0.01).The NAA/Cr ratio on left prefrontal lobe of negative subtype patients pre-treatment was significantly negatively related with the score of negative symptoms and the perseverant errors of WCST respectively(r=-0.35,P<0.05);(r=-0.36,P<0.01),respectively.On left prefrontal lobe of negative subtype schizophrenics post-treatment,the changes of NAA/Cr were negatively related with the improvement of the score of negative symptoms and the perseverant errors(r=-0.30,P<0.05);(r=-0.29,P<0.05),respectively,and positively related with the alteration of the categories completed(r=0.31,P<0.05).Conclusion:The negative subtype schizophrenics and the positive subtype schizophrenics possibly display different basis of neurobiology.The damage of neurons in left prefrontal lobe of negative subtype schizophrenics may be the root cause of negative symptom and executive dysfunction.更多还原