【摘要】 目的采用基于体素的形态学分析(VBM)和基于表面的形态学分析(SBA)相结合的分析方法,探讨成年早期首次发病精神分裂症患者脑皮层改变区域,并寻找与精神症状相关的皮层改变脑区。方法依据入组标准,纳入成年早期首次发病精神分裂症患者25例,招募25名健康志愿者为对照组,进行全脑磁共振扫描,获取3D脑结构图像,通过VBM8计算脑皮层体积,通过Free Surfer软件计算脑皮层厚度与表面积,分别比较患者组和正常对照组间的差异,并将有差异脑区的皮层与PANSS评分(总评分、阳性症状评分、阴性症状评分及一般病理评分)进行相关性分析。结果患者组左侧额叶直回、中央前回、颞中回、顶上小叶及右侧额上回、颞中回、颞上回、海马旁回、楔叶皮层体积与正常对照组相比减少,差异有统计学意义(P<0.05);患者组左半球中的舌叶、颞下回、额中回后部及右半球中的颞下回、中央旁小叶、纺锤体、额上回、额中回后部皮层厚度与正常对照组相比,差异有统计学意义(P<0.05);患者组皮层表面积与正常对照组比较,差异无统计学意义。左半球中额中回后部皮层厚度与PANSS阴性评分、PANNS总评分呈负相关(P<0.05);右半球中额上回皮层厚度与PANSS阴性评分呈负相关(P<0.05)。结论成年早期首次发病精神分裂症患者存在多个脑区灰质体积及皮层厚度异常,且有部分脑区的皮层厚度与患者精神症状严重程度相关。更多还原

【Abstract】 Objective To investigate changes in brain cortical surface in patients with early adulthood episode schizophrenia with voxel-based morphometry( VBM) and surface based analysis( SBA),and the correlations between regional cortical thickness and symptom severity. Methods According to the inclusion criteria,25 patients with early adulthood episode schizophrenia were included in a group of patients,and 25 healthy volunteers as a normal control group. Each participates received whole brain MRI scans,then the 3D brain structural MRI images were obtained. The gray matter volume differences between patients and controls were analyzed by using VBM8. By applying Freesurfer,the cortical thickness and surface of two groups were compared. Correlations between PANSS score( PANSS positive symptom score,PANSS negative symptom score,PANSS general score,PANSS total score) and the local abnormal cortical were computed by Pearson correlation analysis. Results Compared to the normal controls,the patients had multiple brain areas abnormal volumes. It showed significant decreased gray matter volume in the left rectal gyrus,left anterior central convolution,left middle temporal gyrus,left inferior parietal lobule and the right middle temporal gyrus,right superior temporal gyrus,right parahippocampal gyrus,right cuneus. The patients showed significantly decreased cortical thickness in left lingual,left inferior temporal,left caudal middle frontal,right inferior temporal,right paracentral,right fusiform,right superior frontal and right caudal middle frontal regions. There was no significant difference with the cortical surface between the two groups. Within the patients group,left caudal middle frontal region was positively correlated with PANSS negative symptom score and PANSS total score; and the right superior frontal region was PANSS negative symptom score. Conclusion Multiple cortical thickness abnormality regions are present in patients with early adulthood episode schizophrenia,and the cortical thickness is associated with symptoms severity.更多还原