Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil.
Psychiatry Res. 2012 Jun 30;202(3):198-205. doi: 10.1016/j.pscychresns.2011.09.005. Epub 2012 Jul 16.
The occurrence of white matter (WM) abnormalities in psychotic disorders has been suggested by several studies investigating brain pathology and diffusion tensor measures, but evidence assessing regional WM morphometry is still scarce and conflicting. In the present study, 122 individuals with first-episode psychosis (FEP) (62 fulfilling criteria for schizophrenia/schizophreniform disorder, 26 psychotic bipolar I disorder, and 20 psychotic major depressive disorder) underwent magnetic resonance imaging, as well as 94 epidemiologically recruited controls. Images were processed with the Statistical Parametric Mapping (SPM2) package, and voxel-based morphometry was used to compare groups (t-test) and subgroups (ANOVA). Initially, no regional WM abnormalities were observed when both groups (overall FEP group versus controls) and subgroups (i.e., schizophrenia/schizophreniform, psychotic bipolar I disorder, psychotic depression, and controls) were compared. However, when the voxelwise analyses were repeated excluding subjects with comorbid substance abuse or dependence, the resulting statistical maps revealed a focal volumetric reduction in right frontal WM, corresponding to the right middle frontal gyral WM/third subcomponent of the superior longitudinal fasciculus, in subjects with schizophrenia/schizophreniform disorder (n=40) relative to controls (n=89). Our results suggest that schizophrenia/schizophreniform disorder is associated with right frontal WM volume decrease at an early course of the illness.
几项研究通过调查脑病理学和弥散张量测量结果表明，精神障碍患者存在脑白质（WM）异常。但是，评估区域性 WM 形态计量的证据仍然很少且相互矛盾。在本研究中，122 名首发精神病患者（FEP）（62 名符合精神分裂症/分裂情感障碍标准，26 名精神病性双相 I 障碍，20 名精神病性重度抑郁症）接受了磁共振成像检查，同时还招募了 94 名符合条件的对照组。图像由统计参数映射（SPM2）包进行处理，体素基于形态测量学用于比较组（t 检验）和亚组（即精神分裂症/分裂情感障碍、精神病性双相 I 障碍、精神病性重度抑郁症和对照组）。最初，当将两组（总体 FEP 组与对照组）和亚组（即精神分裂症/分裂情感障碍、精神病性双相 I 障碍、精神病性重度抑郁症和对照组）进行比较时，未观察到区域性 WM 异常。但是，当排除合并物质滥用或依赖的受试者后，重复进行体素分析，结果的统计图谱显示精神分裂症/分裂情感障碍患者（n=40）右侧额 WM 存在局灶性体积减少，对应右侧额中回 WM/上纵束第三亚成分，与对照组（n=89）相比。我们的研究结果表明，精神分裂症/分裂情感障碍在疾病早期与右侧额 WM 体积减少有关。
