Zhang Zhijun, Shi Jiabo, Yuan Yonggui, Hao Guifeng, Yao Zhijian, Chen Ning
The Department of Neuropsychiatry, Affiliated ZhongDa Hospital of Southeast University, Nanjing, China.
J Psychiatr Res. 2008 May;42(6):477-86. doi: 10.1016/j.jpsychires.2007.04.003. Epub 2007 Aug 1.
The purpose of this study was to explore whether there are differences in cerebral asymmetry between subgroups of schizophrenic patients with or without auditory verbal hallucinations (AVHs) and normal controls by using event-related functional magnetic resonance imaging (efMRI). A total of 26 Chinese Han male patients with paranoid schizophrenia (diagnosed by DSM IV, including 13 patients with AVHs and 13 patients without) and 13 matched normal controls were recruited for the present study. The participants had been instructed to listen to short sentences from left or right side and to indicate laterality during efMRI scanning. Functional data were acquired using a 1.5T MR, and were analyzed using statistical parametric mapping. A random-effect model was employed to asses the difference in blood oxygen level dependent response between "left-sided" and "right-sided" conditions. The results from the present study have shown (1) within group comparisons: right precuneus and right superior parietal lobule were significantly activated showed significantly greater activation by left-sided voices than right-sided ones in controls. However, no significant difference in activation was found in any brain region between left and right-sided voices in either of the two patient subgroups, (2) between group comparisons: in comparison with AVHs patients, right middle frontal gyrus (MFG) was markedly activated when control subjects were differentiating right-sided voices. In comparison with patients without AVHs, right-side stimuli significantly activated bilateral MFG and left postcentral gyrus in control group. Furthermore, compared to the non-hallucination group, left Wernicke's area, including supramarginal gyrus, angular gyrus and superior temporal gyrus, was significantly activated by both left and right-sided voices in the hallucination group. In summary, auditory-related asymmetry in control subjects is attenuated in schizophrenic patients. The symptoms of AVHs in schizophrenia are possibly correlated with left hemispheric, particularly auditory and language-related areas dysfunction.
本研究旨在通过使用事件相关功能磁共振成像（efMRI），探讨有或无幻听（AVH）的精神分裂症患者亚组与正常对照组之间脑不对称性是否存在差异。本研究共招募了26名中国汉族男性偏执型精神分裂症患者（根据DSM-IV诊断，其中13名有AVH，13名无AVH）以及13名匹配的正常对照。参与者被要求在efMRI扫描期间听来自左侧或右侧的短句并指出方向。使用1.5T磁共振成像获取功能数据，并使用统计参数映射进行分析。采用随机效应模型评估“左侧”和“右侧”条件下血氧水平依赖反应的差异。本研究结果表明：（1）组内比较：右侧楔前叶和右侧顶上小叶在对照组中被左侧声音激活的程度显著高于右侧声音。然而，在两个患者亚组中，左侧和右侧声音在任何脑区的激活均无显著差异；（2）组间比较：与有AVH的患者相比，对照组在区分右侧声音时右侧额中回（MFG）明显激活。与无AVH的患者相比，右侧刺激在对照组中显著激活双侧MFG和左侧中央后回。此外，与无幻觉组相比，幻觉组中左侧和右侧声音均显著激活左侧韦尼克区，包括缘上回、角回和颞上回。总之，精神分裂症患者中对照组与听觉相关的不对称性减弱。精神分裂症中AVH症状可能与左侧半球功能障碍有关，尤其是听觉和语言相关区域。
