青少年精神分裂症首次发病患者脑灰质体积与认知功能的相关性

摘要

Objective:To investigate the relationship between brain gray matter volume and cognitive function in the first-episode adolescent schizophrenia. Method:Thirty-three first-episode adolescent schizo-phrenia patients( patient group)and twenty-eight gender,age,right-handed,education level matched normal control group were recruited,and neuropsychological tests including trail marking test,symbol coding,verbal fluency test,Hopkins verbal learning test-revised(HVLT-R),brief visuospatial menmory test-revised(BVMT-R),Stroop color word test(ST-1,ST-2,ST-3),maze test and structural magnetic resonance imaging(s-MRI) were conducted. The gray matter volume in two groups was andyzed and compared by the voxel-based morphom-etry(VBM). Results:Trail marking tests in the patient group were higher than those of the control group(t =2. 08,P < 0. 05),symbol coding(t = - 4. 36),HVLT-R(t = - 3. 74),BVMT-R(t = - 4. 83),ST-1,ST-2,ST-3 (t = - 3. 08,t = - 3. 85,t = - 3. 62)and maze test(t = - 3. 14)were lower than the control group(P < 0. 01 or P < 0. 001). Compared with the control group,the patients showed decrease in the right superior temporal gyrus and right middle temporal gyrus(t = - 3. 868,t = 3. 964,all P < 0. 001). Pearson correlation analysis indicated symbol coding(r = 0. 373,P = 0. 032)and maze test quiz scores(r = 0. 356,P = 0. 042)showed positive corre-lation with the right middle temporal gyrus gray matter volume in the patient group. Conclusion:The first-epi-sode adolescent schizophrenia patients present the abnormalities of brain gray matter volume,and this may be re-lated to the widespread impairment of cognitive function.%目的：探讨首发青少年精神分裂症患者脑灰质体积与认知功能的关系。方法：33例首发青少年精神分裂症患者（患者组）和28名性别、年龄、右利手、受教育程度与之相匹配的正常对照组进行神经心理测评，包括连线测验、符号编码、词语流畅性测验、霍普金斯词语学习测验-修订版（HVLT-R）、简易视觉记忆测验-修订版（BVMT-R）、Stroop 色词测验（ST-1、ST-2、ST-3）及迷宫测验和结构磁共振扫描（sMRI）；用基于体素的形态学方法（VBM））分析比较两组脑灰质体积。结果：患者组除连线测验成绩显著高于正常对照组外（t =2.08，P <0.05），符号编码（t =-4.36）、HVLT-R（t =-3.74）、BVMT-R（t =-4.83）、ST-1、ST-2、ST-3（t =-3.08，t =-3.85，t =-3.62）及迷宫测验（t =-3.14）成绩明显低于正常对照组（P <0.01或 P <0.001）。患者组右侧颞上回及右侧颞中回脑灰质体积较正常对照组明显减小（t =-3.868，t =3.964；P 均<0.001）。Pearson 相关分析显示，患者组符号编码（r =0.373，P =0.032）及迷宫测验评分（r =0.356，P =0.042）与右侧颞中回脑灰质体积正相关。结论：首发青少年精神分裂症患者存在脑灰质体积异常；这可能与认知功能广泛损害相关。