Agarwal Nivedita, Rambaldelli Gianluca, Perlini Cinzia, Dusi Nicola, Kitis Omer, Bellani Marcella, Cerini Roberto, Isola Miriam, Versace Amelia, Balestrieri Matteo, Gasparini Anna, Mucelli Roberto Pozzi, Tansella Michele, Brambilla Paolo
Department of Medical and Morphological Research, Section of Radiology, University of Udine, Udine, Italy.
J Psychiatry Neurosci. 2008 Sep;33(5):440-8.
Several magnetic resonance imaging (MRI) and postmortem studies have supported the role of the thalamus in the pathophysiology of schizophrenia. Interestingly, a recent small diffusion weighted imaging (DWI) study showed abnormal thalamic microstructure in patients with schizophrenia. The objective of our study was to use structural MRI and DWI to explore for the first time both thalamic volumes and integrity in schizophrenia.
We measured thalamic volumes and apparent diffusion coefficient (ADC) measures bilaterally in 71 patients with schizophrenia, representative of those living in the geographically defined catchment area of South Verona (i.e., 100 000 inhabitants), and 75 individuals without schizophrenia. The presence of the adhesio interthalamica was also detected.
We found no significant differences in thalamus size between patients with schizophrenia and participants in the control group, with only a trend for decreased left volumes. No abnormal frequency of the adhesio interthalamica was found. In contrast, significantly increased thalamic ADC values were shown in schizophrenia patients. Age significantly inversely correlated with thalamic volumes in both groups and correlated positively with posterior ADCs in patients with schizophrenia. No significant associations between clinical variables and either volumes or ADC values were reported.
Widespread altered microstructure integrity and partially preserved thalamus size were found in schizophrenia patients. Therefore, subtle thalamic structural abnormalities are present in schizophrenia, even with maintained volumes. This may result from disruption at the cytoarchitecture level, ultimately supporting corticothalamic misconnection. Future imaging studies should further explore thalamic tissue coherence and its role for cognitive disturbances in patients at high risk for schizophrenia and in first-degree relatives.
多项磁共振成像（MRI）及尸检研究均支持丘脑在精神分裂症病理生理学中的作用。有趣的是，最近一项小型扩散加权成像（DWI）研究显示，精神分裂症患者丘脑微观结构异常。我们研究的目的是首次使用结构MRI和DWI来探究精神分裂症患者的丘脑体积及完整性。
我们对71例精神分裂症患者双侧丘脑体积及表观扩散系数（ADC）进行了测量，这些患者来自南维罗纳地理界定集水区（即10万居民），具有代表性，同时测量了75名无精神分裂症个体。还检测了丘脑间粘连的存在情况。
我们发现精神分裂症患者与对照组参与者之间丘脑大小无显著差异，仅左侧体积有减小趋势。未发现丘脑间粘连频率异常。相比之下，精神分裂症患者丘脑ADC值显著升高。两组中年龄均与丘脑体积呈显著负相关，在精神分裂症患者中年龄与后部ADC值呈正相关。未报告临床变量与体积或ADC值之间存在显著关联。
精神分裂症患者存在广泛的微观结构完整性改变及部分保留的丘脑大小。因此，即使体积保持正常，精神分裂症患者仍存在细微的丘脑结构异常。这可能是由于细胞结构水平的破坏所致，最终支持皮质丘脑连接错误。未来的影像学研究应进一步探索丘脑组织连贯性及其在精神分裂症高危患者及一级亲属认知障碍中的作用。
