Nakamura Motoaki, McCarley Robert W, Kubicki Marek, Dickey Chandlee C, Niznikiewicz Margaret A, Voglmaier Martina M, Seidman Larry J, Maier Stephan E, Westin Carl-Fredrik, Kikinis Ron, Shenton Martha E
Clinical Neuroscience Division, Department of Psychiatry, Veterans Affairs Boston Healthcare System, Brockton Division, Harvard Medical School, MA 02301, USA.
Biol Psychiatry. 2005 Sep 15;58(6):468-78. doi: 10.1016/j.biopsych.2005.04.016. Epub 2005 Jun 22.
Using diffusion tensor imaging (DTI), we previously reported abnormalities in two critical white matter tracts in schizophrenia, the uncinate fasciculus (UF) and the cingulum bundle (CB), both related to fronto-temporal connectivity. Here, we investigate these two bundles in unmedicated subjects with schizotypal personality disorder (SPD).
Fifteen male SPD subjects and 15 male control subjects were scanned with line-scan DTI. Fractional anisotropy (FA) and mean diffusivity (D(m)) were used to quantify water diffusion, and cross-sectional area was defined with a directional threshold method. Exploratory correlation analyses were evaluated with Spearman's rho, followed by post hoc hierarchical regression analyses.
We found bilaterally reduced FA in the UF of SPD subjects. For CB, there was no significant group difference for FA or D(m) measures. Additionally, in SPD, reduced FA in the right UF was correlated with clinical symptoms, including ideas of reference, suspiciousness, restricted affect, and social anxiety. In contrast, left UF area was correlated with measures of cognitive function, including general intelligence, verbal and visual memory, and executive performance.
These findings in SPD suggest altered fronto-temporal connectivity through the UF, similar to findings in schizophrenia, and intact neocortical-limbic connectivity through the CB, in marked contrast with what has been reported in schizophrenia.
我们之前利用扩散张量成像（DTI）报告了精神分裂症患者两条关键白质束——钩束（UF）和扣带束（CB）的异常，这两条束均与额颞叶连接有关。在此，我们对未服药的分裂型人格障碍（SPD）患者的这两条束进行研究。
对15名男性SPD患者和15名男性对照者进行线扫描DTI检查。采用分数各向异性（FA）和平均扩散率（D(m)）来量化水扩散，并采用方向阈值法定义横截面积。用Spearman等级相关系数进行探索性相关分析，随后进行事后分层回归分析。
我们发现SPD患者双侧钩束的FA降低。对于扣带束，FA或D(m)测量值无显著组间差异。此外，在SPD患者中，右侧钩束FA降低与临床症状相关，包括牵连观念、猜疑、情感受限和社交焦虑。相比之下，左侧钩束面积与认知功能指标相关，包括一般智力、言语和视觉记忆以及执行能力。
SPD患者的这些发现表明，通过钩束的额颞叶连接发生改变，与精神分裂症的发现相似；而通过扣带束的新皮质 - 边缘系统连接完整，这与精神分裂症的报道形成显著对比。
