Kawashima Toshiro, Nakamura Motoaki, Bouix Sylvain, Kubicki Marek, Salisbury Dean F, Westin Carl-Fredrik, McCarley Robert W, Shenton Martha E
Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Boston Veterans Affairs Healthcare System, Brockton Division, Harvard Medical School, Brockton, MA 02301, USA.
Schizophr Res. 2009 May;110(1-3):119-26. doi: 10.1016/j.schres.2009.01.014. Epub 2009 Mar 28.
Two of the most frequently investigated regions in diffusion tensor imaging studies in chronic schizophrenia are the uncinate fasciculus (UF) and cingulum bundle (CB). The purpose of the present study was to determine whether UF and CB white matter integrity were altered at the early stage of illness and specific to schizophrenia. Fifteen schizophrenia subjects and 15 affective psychosis within 4 years of first hospitalization (12 patients with schizophrenia and 12 patients with affective psychosis during their first hospitalization), and 15 psychiatrically healthy controls underwent line-scan diffusion tensor imaging. 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. Bilaterally reduced FA, but not D(m), was present in the UF of schizophrenia compared with healthy controls. Affective psychosis was intermediate between schizophrenia subjects and healthy controls, but not significantly different from either. For CB, there was no significant group difference for FA or D(m). These findings suggest that UF, but not CB, white matter integrity is altered at the early stage of illness in schizophrenia although it may not be specific to schizophrenia. The CB abnormalities reported in chronic schizophrenia may develop during the later course of the disease.
在慢性精神分裂症的扩散张量成像研究中,两个最常被研究的区域是钩束(UF)和扣带束(CB)。本研究的目的是确定UF和CB的白质完整性在疾病早期是否发生改变,以及是否为精神分裂症所特有。15名精神分裂症患者、15名首次住院4年内的情感性精神病患者(首次住院时12名精神分裂症患者和12名情感性精神病患者)以及15名精神健康对照者接受了线扫描扩散张量成像。采用分数各向异性(FA)和平均扩散率(D(m))来量化水扩散,并使用方向阈值法定义横截面积。与健康对照相比,精神分裂症患者的UF双侧FA降低,但D(m)未降低。情感性精神病患者的FA介于精神分裂症患者和健康对照之间,但与两者均无显著差异。对于CB,FA或D(m)在各组间无显著差异。这些发现表明,精神分裂症患者在疾病早期UF的白质完整性发生改变,但CB未改变,尽管这可能并非精神分裂症所特有。慢性精神分裂症中报道的CB异常可能在疾病后期出现。