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反社会型人格障碍成年人额叶白质微观结构异常。

White matter microstructural abnormalities in the frontal lobe of adults with antisocial personality disorder.

机构信息

King's College London, Institute of Psychiatry, Department of Forensic and Neurodevelopmental Science, London, UK; Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland.

出版信息

Cortex. 2012 Feb;48(2):216-29. doi: 10.1016/j.cortex.2011.06.005. Epub 2011 Jul 21.

Abstract

UNLABELLED

Antisocial personality disorder (ASPD) and psychopathy involve significant interpersonal and behavioural impairments. However, little is known about their underlying neurobiology and in particular, abnormalities in white matter (WM) microstructure. A preliminary diffusion tensor magnetic resonance imaging (DT-MRI) study of adult psychopaths employing tractography revealed abnormalities in the right uncinate fasciculus (UF) (Craig et al., 2009), indicating fronto-limbic disconnectivity. However, it is not clear whether WM abnormalities are restricted to this tract or are or more widespread, including other tracts which are involved in connectivity with the frontal lobe. We performed whole brain voxel-based analyses on WM fractional anisotropy (FA) and mean diffusivity (MD) maps acquired with DT-MRI to compare 15 adults with ASPD and healthy age, handedness and IQ-matched controls. Also, within ASPD subjects we related differences in FA and MD to measures of psychopathy. Significant WM FA reduction and MD increases were found respectively in ASPD subjects relative to controls. FA was bilaterally reduced in the genu of corpus callosum while in the right frontal lobe FA reduction was found in the UF, inferior fronto-occipital fasciculus (IFOF), anterior corona radiata and anterior limb and genu of the internal capsule. These differences negatively correlated with measures of psychopathy. Also in the right frontal lobe, increased MD was found in the IFOF and UF, and the corpus callosum and anterior corona radiata. There was a significant positive correlation between MD and psychopathy scores.

CONCLUSIONS

The present study confirms a previous report of reduced FA in the UF. Additionally, we report for the first time, FA deficits in tracts involved in interhemispheric as well as frontal lobe connectivity in conjunction with MD increases in the frontal lobe. Hence, we provide evidence of significant WM microstructural abnormalities in frontal brain regions in ASPD and psychopathy.

摘要

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反社会人格障碍(ASPD)和精神病态涉及严重的人际和行为障碍。然而,人们对其潜在的神经生物学知之甚少,特别是对大脑白质(WM)微观结构的异常知之甚少。一项使用轨迹法对成年精神病患者进行的初步扩散张量磁共振成像(DT-MRI)研究显示,右侧钩束(UF)异常(Craig 等人,2009 年),表明额-边缘连接中断。然而,目前尚不清楚 WM 异常是否仅限于该束,还是更广泛,包括与额叶连接的其他束。我们对 WM 分数各向异性(FA)和平均弥散度(MD)图进行了全脑基于体素的分析,以比较 15 名 ASPD 患者和年龄、手性和 IQ 匹配的健康对照组。此外,在 ASPD 患者中,我们还将 FA 和 MD 的差异与精神病态的测量值相关联。与对照组相比,ASPD 患者的 WM FA 降低和 MD 增加。胼胝体体部双侧 FA 降低,右侧 UF、下额枕束(IFOF)、前放射冠和内囊前肢和体部 FA 降低。这些差异与精神病态的测量值呈负相关。此外,在右侧额叶,IFOF 和 UF 以及胼胝体和前放射冠的 MD 增加。MD 与精神病态评分呈显著正相关。

结论

本研究证实了之前关于 UF 中 FA 降低的报道。此外,我们首次报道了与额叶连接的半球间束和额叶内 FA 缺陷以及额叶内 MD 增加。因此,我们为 ASPD 和精神病态的额叶脑区 WM 微观结构异常提供了证据。

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