青少年首发未用药精神分裂症患者脑灰质改变

摘要

Objective To investigate gray matter structural damage in first-episode antipsychotic-naïve patients with adolescent-onset schizophrenia. Methods Twenty-six patients with schizophrenia and 26 healthy controls were scanned by using GE 3.0T magnetic resonance imaging in order to explore brain gray matter volume (GMV) changes with registration techniques based on the latest morphological deformation field theory. The correlation of gray matter volume abnormalities with clinical severity was also analyzed. Results Compared with healthy controls, patients with adoles-cent-onset schizophrenia showed significant reduction in GMV in the left parietal lobe, parahippocampal gyrus and right cerebellar pyramis. GMV of the left parahippocampal gyrus is significantly correlated with PANSS paranoid scores (r=-0.49, P=0.02). Conclusions There is structural abnormality in GM in parahippocampal-parietal-cerebellar in pa-tients with adolescent-onset schizophrenia and the severity of paranoid symptoms is related to the reduced GMV in the left parahippocampal gyrus.%目的：探讨青少年首发未用药精神分裂症患者的脑灰质结构损害特征及其与临床特征的相关性。方法应用GE 3.0T磁共振成像仪对26例青少年首发精神分裂症患者与26名青少年正常对照进行头颅结构磁共振扫描获得3D脑结构图像，采用基于变形场理论的最新形态学配准技术（diffeomorphic anatomi-cal registration using the exponentiated lie algebra ，DARTEL）对脑灰质体积进行分析，并对患者异常的灰质体积与临床症状严重程度进行相关性分析。结果与对照组相比，患者组灰质体积下降区域为左侧顶叶中央后回、边缘叶海马旁回以及右侧小脑后叶蚓锥体，两组间差异均有统计学意义（P<0.001，未校正）。偏相关分析显示，左侧海马旁回灰质体积与PANSS偏执分（r=-0.49，P=0.02）存在相关，余灰质损害脑区与临床特征均无统计学相关性（P>0.05）。结论青少年首发精神分裂症患者脑结构损害模式为小脑-边缘叶（海马旁回）-顶叶的脑结构异常，患者的偏执症状与左侧海马旁回灰质损害有关。