Szulc Agata, Galińska Beata, Tarasów Eugeniusz, Walecki Jerzy, Dzienis Wojciech, Kubas Bozena, Czernikiewicz Andrzej
Kliniki Psychiatrii AM w Białymstoku.
Psychiatr Pol. 2003 Nov-Dec;37(6):977-88.
This study examined 1H MRS detected metabolite levels (in left frontal, temporal lobes and thalamus) and clinical and cognitive features of patients with first-episode and chronic schizophrenia.
We studied 31 first-episode patients (group 1) and 17 chronic patients (group 2) with ICD-10 diagnosis of schizophrenia (and 13 healthy subjects). Patients were also assessed by the means of PANSS, CGI, Calgary scales and WCST, TMT, Stroop tests.
We did not observe statistically significant differences in metabolite levels between group 1 and 2. We observed only a trend toward higher Cho level in temporal lobe in group 2 and lower NAA level in group 1. When comparing with the control group we observed a significantly higher Cho level in the frontal lobe (group 1,2) (p < 0.05). We observed a trend toward lower NAA levels in the frontal lobe (group 1,2), and lower NAA level in the temporal lobe (group 1). Patients with chronic schizophrenia performed significantly worse in WCST, TMT and Stroop tests (p < 0.05).
These results suggest, that abnormalities in metabolite levels in frontal and temporal lobes are present at the onset of disease and don't progress over time. The cognitive dysfunction is more prominent in chronic patients.
本研究检测首发及慢性精神分裂症患者的1H MRS检测代谢物水平(左额叶、颞叶和丘脑)以及临床和认知特征。
我们研究了31例首发患者(第1组)和17例慢性患者(第2组),他们均符合ICD - 10精神分裂症诊断标准(另有13名健康受试者)。患者还通过阳性和阴性症状量表(PANSS)、临床总体印象量表(CGI)、卡尔加里量表以及威斯康星卡片分类测验(WCST)、连线测验(TMT)、斯特鲁普测验进行评估。
我们未观察到第1组和第2组之间代谢物水平存在统计学显著差异。仅观察到第2组颞叶中胆碱(Cho)水平有升高趋势,第1组中N - 乙酰天门冬氨酸(NAA)水平有降低趋势。与对照组相比,我们观察到额叶中Cho水平显著更高(第1组、第2组)(p < 0.05)。我们观察到额叶中NAA水平有降低趋势(第1组、第2组),颞叶中NAA水平有降低趋势(第1组)。慢性精神分裂症患者在WCST、TMT和斯特鲁普测验中的表现明显更差(p < 0.05)。
这些结果表明,额叶和颞叶代谢物水平异常在疾病发作时就已存在,且不会随时间进展。认知功能障碍在慢性患者中更为突出。