Institute of Mental Health/Woodbridge Hospital, Singapore.
Clin Psychopharmacol Neurosci. 2012 Apr;10(1):13-24. doi: 10.9758/cpn.2012.10.1.13. Epub 2012 Apr 30.
Earlier structural magnetic resonance imaging in schizophrenia have noted smaller white matter volumes in diverse brain regions and recent diffusion tensor imaging (DTI) studies have allowed better elucidation of changes in brain white matter integrity within the illness. As white matter abnormalities have been reported to occur early in the course of schizophrenia, we systematically review extant DTI studies of anomalies of white matter integrity in first episode schizophrenia (FES) up till October 2011. Overall, disruptions of white matter integrity were found in the cortical, subcortical brain regions and white matter associative and commissural tracts, suggesting that changes of cortical-subcortical white matter integrity were found at an early stage of the disorder. These changes in white matter integrity were correlated with specific cognitive deficits (verbal and spatial working memory) as well as psychopathology (positive more than negative symptoms) in patients with FES. The correlation of these white matter integrity changes with cognitive and phenomenological factors may shed light on neurobiological substrates underlying these clinical manifestations. Future studies need to validate these findings in larger samples of subjects and in different populations as well as chart the progress of these cerebral white matter changes over time so as to better appreciate their trajectory with illness course, treatment and chronicity.
早期精神分裂症的结构磁共振成像已经注意到不同脑区的白质体积较小，而最近的弥散张量成像（DTI）研究允许更好地阐明疾病过程中脑白质完整性的变化。由于已经报道了白质异常在精神分裂症的早期发生，我们系统地回顾了截至 2011 年 10 月，首次发作精神分裂症（FES）中白质完整性异常的现有 DTI 研究。总的来说，在皮质、皮质下脑区和白质联合及连合束中发现了白质完整性的中断，这表明皮质-皮质下白质完整性的变化发生在疾病的早期阶段。这些白质完整性的变化与 FES 患者的特定认知缺陷（言语和空间工作记忆）以及精神病理学（阳性症状多于阴性症状）相关。这些白质完整性变化与认知和现象学因素的相关性可能揭示了这些临床表现背后的神经生物学基础。未来的研究需要在更大的样本和不同人群中验证这些发现，并跟踪这些大脑白质变化随时间的进展，以便更好地了解它们与疾病过程、治疗和慢性的轨迹。
