【摘要】 目的探讨首发未用药的偏执型精神分裂症患者的多个脑区白质磁共振弥散张量成像(diffusion tensor imaging,DTI)的特点,以期为精神分裂症"脑内连接异常的假说"提供依据。方法选取20例首发偏执型精神分裂症患者,应用DTI扫描,检测脑内21个感兴趣区(regions of interest,ROI)白质纤维的微细结构,并与20名年龄、性别和文化程度相匹配的正常对照比较。结果患者组额叶、内囊前肢、外囊的左右两侧FA值和左侧颞叶、左侧内囊膝部、胼胝体膝部FA值小于对照组(P<0.05)。患者组额叶左右侧FA值差异无统计学意义(P>0.05),而对照组左侧大于右侧(P<0.05);患者组内囊膝部和后肢FA值右侧大于左侧(P<0.05),而对照组左侧大于右侧(P<0.05)。患者组双侧外囊FA值均小于对照组(P<0.05)。结论未用药首发偏执型精神分裂症患者脑内多个白质区部分各向异性降低,尤其是额叶皮层下环路更加显著,数个白质区部分各向异性的正常"左>右"的偏侧性缺失或倒置,支持精神分裂症脑内连接异常的神经病理假说。更多还原

【Abstract】 Objective To evaluate the fractional anisotropy of white matter fibers in some regions of interest (ROI) in the brain of the first-episode patients with paranoid schizophrenia and to provide further evidence for the disconnection hypothesis of schizophrenia.Methods Twenty first-episode patients with paranoid schizophrenia and twenty health controls paired with sex,age (±3 years old) and education were scanned by multi-vowel proton MR and diffusion tensor imaging.The spectra were obtained from a 1.5 T MR scanner by PRESS sequence with TR/TE of 1000/144ms.The fractional anisotropy (FA) was measured in 21 regions of interest.Results The mean values of FA of the bilateral frontal lobe,bilateral anterior limb of internal capsule,bilateral external capsule,left temporal lobe,left lap of internal capsule and lap of corpus callosum in the patients group were significant lower than those in the health control group (P<0.05).The value of FA was no significant difference between the bilateral frontal lobe in the patient group (P>0.05),whereas The value of FA was higher in the left frontal lobe than in the right frontal lobe (P<0.05).The values of FA of the lap and posterior limb of internal capsule in the patient group were higher in the left hemisphere than in the right hemisphere,whereas The values of FA of the lap and posterior limb of internal capsule in health control group were higher in the right hemisphere than in the left hemisphere (P<0.05).The value of FA in the external capsule in the both groups were lower in the right hemisphere than the left hemisphere (P<0.05).Conclusions Patients with first-episode paranoid schizophrenia have significant reduction of white matter fractional anisotropy in multiple brain regions,particularly in the circuit loop of frontal lobe-subcortex.In addition,the normal left>right lateralization is absent or reversed in patients,which supports the disconnection hypothesis of schizophrenia.更多还原