Walterfang Mark, McGuire Philip K, Yung Alison R, Phillips Lisa J, Velakoulis Dennis, Wood Stephen J, Suckling John, Bullmore Edward T, Brewer Warrick, Soulsby Bridget, Desmond Patricia, McGorry Patrick D, Pantelis Christos
Melbourne Neuropsychiatry Centre, Level 2, Royal Melbourne Hospital, 3050 Australia.
Br J Psychiatry. 2008 Sep;193(3):210-5. doi: 10.1192/bjp.bp.107.043463.
Grey matter changes have been described in individuals who are pre- and peri-psychotic, but it is unclear if these changes are accompanied by changes in white matter structures.
To determine whether changes in white matter occur prior to and with the transition to psychosis in individuals who are pre-psychotic who had previously demonstrated grey matter reductions in frontotemporal regions.
We used magnetic resonance imaging (MRI) to examine regional white matter volume in 75 people with prodromal symptoms. A subset of the original group (n=21) were rescanned at 12-18 months to determine white matter volume changes. Participants were retrospectively categorised according to whether they had or had not developed psychosis at follow-up.
Comparison of the baseline MRI data from these two subgroups revealed that individuals who later developed psychosis had larger volumes of white matter in the frontal lobe, particularly in the left hemisphere. Longitudinal comparison of data in individuals who developed psychosis revealed a reduction in white matter volume in the region of the left fronto-occipital fasciculus. Participants who had not developed psychosis showed no reductions in white matter volume but increases in a region subjacent to the right inferior parietal lobule.
The reduction in volume of white matter near the left fronto-occipital fasciculus may reflect a change in this tract in association with the onset of frank psychosis.
在精神病发作前及发作期间的个体中，已发现灰质有变化，但尚不清楚这些变化是否伴有白质结构的改变。
确定在先前已显示额颞叶区域灰质减少的精神病前期个体中，白质变化是否先于精神病发作并伴随发作过程出现。
我们使用磁共振成像（MRI）检查了75名有前驱症状者的区域白质体积。对原始组中的一个子集（n = 21）在12至18个月时进行了重新扫描，以确定白质体积的变化。根据随访时是否出现精神病，对参与者进行回顾性分类。
对这两个亚组的基线MRI数据进行比较发现，后来出现精神病的个体额叶白质体积更大，尤其是在左半球。对出现精神病的个体的数据进行纵向比较发现，左额枕束区域的白质体积减少。未出现精神病的参与者白质体积没有减少，但右下顶叶小叶下方的一个区域有所增加。
左额枕束附近白质体积的减少可能反映了该束与明显精神病发作相关的变化。
