Kyriakopoulos Marinos, Frangou Sophia
Section of Neurobiology of Psychosis, NIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, King's College London, London, UK.
Curr Opin Psychiatry. 2009 Mar;22(2):168-76. doi: 10.1097/YCO.0b013e328325aa23.
Several lines of evidence suggest that the normal integration of cerebral function may be compromised in schizophrenia. Abnormalities in white matter tracts, which connect brain regions into functional networks, may be directly relevant to its pathophysiology. Diffusion tensor imaging (DTI) has increasingly been used to study white matter abnormalities in schizophrenia; in this review, we will discuss recent DTI findings focusing on the early stages of the disorder.
Deficits in white matter integrity as inferred by DTI appear to be present in the early stages of schizophrenia, even in neuroleptic-naive patients, and may be the result of interaction between illness-related processes and normal development. The pattern of identified abnormalities is not totally consistent across all studies, with frontotemporal, frontoparietal and temporooccipital connections as well as projection fibers and cerebellar white matter being among the affected tracts.
Recent DTI findings further support the hypothesis of structural dysconnectivity in schizophrenia. The presence of white matter abnormalities early in the course of the illness is suggestive of these being related to the emergence of the disorder.
多项证据表明，精神分裂症患者大脑功能的正常整合可能受到损害。连接脑区形成功能网络的白质束异常可能与其病理生理学直接相关。扩散张量成像（DTI）越来越多地用于研究精神分裂症的白质异常；在本综述中，我们将讨论近期聚焦于该疾病早期阶段的DTI研究结果。
DTI推断的白质完整性缺陷似乎在精神分裂症早期就已存在，即使在未使用抗精神病药物的患者中也是如此，这可能是疾病相关过程与正常发育相互作用的结果。所有研究中确定的异常模式并不完全一致，受影响的脑区包括额颞叶、额顶叶和颞枕叶连接以及投射纤维和小脑白质。
近期DTI研究结果进一步支持了精神分裂症存在结构连接障碍的假说。疾病早期出现白质异常表明这些异常与疾病的发生有关。
