Department of Psychiatry, Marqués de Valdecilla University Hospital, Avenida Valdecilla s/n, University of Cantabria, Spain.
Neuroimage. 2010 Jan 1;49(1):199-204. doi: 10.1016/j.neuroimage.2009.07.016. Epub 2009 Jul 18.
Disruptions in white matter structure have consistently been shown in schizophrenia--but mainly in patients in whom the illness is well-established. In order to determine whether white matter abnormalities are present at illness onset, and to minimise the potentially confounding effects of chronic illness and treatment, we used diffusion tensor imaging to study a large cohort of first episode psychotic patients who were medication-naive.
Sixty two first episode patients and 54 controls matched on age, sex, years of education and laterality index underwent diffusion tensor imaging. Data were acquired on a GE Signa NVi 1.5 Tesla System. Fractional anisotropy maps were generated on a voxel-by-voxel basis. An optimized voxel-based morphometry technique was conducted with two-stage registration approach. Group differences were examined using a non-parametric statistical method.
The voxelwise analysis revealed four clusters where fractional anisotropy values were significantly lower in patients than controls. These were localised bilaterally to regions of white matter corresponding to superior and inferior longitudinal fasciculus, forceps major, anterior and superior thalamic radiation and corpus callosum.
Reductions in white matter integrity are present early in the course of the schizophrenia and localised in fascicule that connect brain regions implicated in the disorder.
精神分裂症患者的脑白质结构一直存在紊乱，但主要见于疾病已确立的患者。为了确定在疾病发作时是否存在脑白质异常，并最大程度地减少慢性疾病和治疗的潜在混杂影响，我们使用弥散张量成像技术研究了一大群未经药物治疗的首发精神病患者。
62 名首发患者和 54 名年龄、性别、受教育年限和侧性指数匹配的对照者接受了弥散张量成像检查。数据是在 GE Signa NVi 1.5 特斯拉系统上采集的。在体素基础上生成各向异性分数图。采用两阶段登记方法进行优化的基于体素的形态测量技术。使用非参数统计方法检查组间差异。
体素分析显示，与对照组相比，患者的四个脑区的各向异性分数明显降低。这些脑区位于白质的双侧，与上、下纵束、内囊、前、上丘脑辐射和胼胝体相对应。
在精神分裂症的病程早期就存在脑白质完整性的降低，并且局限于与该疾病相关的脑区的束状结构。
