Hüttlova Jitka, Kikinis Zora, Kerkovsky Milos, Bouix Sylvain, Vu Mai-Anh, Makris Nikos, Shenton Martha, Kasparek Tomas
Department of Psychiatry, Masaryk University and University Hospital Brno, Jihlavska 20, 625 00, Brno, Czech Republic.
Cerebellum. 2014 Aug;13(4):415-24. doi: 10.1007/s12311-014-0550-y.
Deficits in the execution of a sequence of movements are common in schizophrenia. Previous studies reported reduced functional activity in the motor cortex and cerebellum in schizophrenic patients with deficits in movement sequencing. The corticospinal tract (CST) and superior cerebellar peduncle (SCP) are fiber tracts that are involved in movement sequencing. However, the integrity of these tracts has not been evaluated in schizophrenic patients with respect to the performance of movement sequencing yet. Diffusion tensor magnetic resonance images (DT-MRI) were acquired from 24 patients with schizophrenia and 23 matched control subjects. Tractography was applied to reconstruct the CST and SCP and DT-MRI-specific parameters such as fractional anisotropy (FA) and radial diffusivity (RD) were reported. The patient group was further subdivided based on the score of sequencing of complex motor acts subscale of the Neurological Evaluation Scale into those with deficits in sequencing motor acts, the SQ(abn) group (n = 7), and those with normal performance, the SQ(norm) group (n = 17). Schizophrenia patients of the SQ(norm) subgroup had significantly reduced FA and increased RD values in the right CST in comparison to the control group; the SQ(abn) subgroup did not differ from the controls. However, the SQ(abn) subgroup showed impaired integrity of the left SCP, whereas the SQ(norm) subgroup did not. Abnormalities in the right CST in the SQ(norm) and in the left SCP in SQ(abn) groups suggest that the patients with SQ(abn) represent subgroups with distinct deficits. Moreover, these results demonstrate the involvement of the SCP in the pathogenesis of movement sequencing in schizophrenia.
在精神分裂症中,一系列动作执行方面的缺陷很常见。先前的研究报告称,在动作序列存在缺陷的精神分裂症患者中,运动皮层和小脑的功能活动有所减少。皮质脊髓束(CST)和小脑上脚(SCP)是参与动作序列的纤维束。然而,尚未针对动作序列表现对这些纤维束在精神分裂症患者中的完整性进行评估。对24名精神分裂症患者和23名匹配的对照受试者进行了扩散张量磁共振成像(DT-MRI)检查。应用纤维束成像技术重建CST和SCP,并报告DT-MRI特定参数,如分数各向异性(FA)和径向扩散率(RD)。根据神经学评估量表复杂运动行为子量表的序列评分,将患者组进一步细分为动作序列存在缺陷的SQ(异常)组(n = 7)和表现正常的SQ(正常)组(n = 17)。与对照组相比,SQ(正常)亚组的精神分裂症患者右侧CST的FA值显著降低,RD值升高;SQ(异常)亚组与对照组无差异。然而,SQ(异常)亚组的左侧SCP完整性受损,而SQ(正常)亚组则没有。SQ(正常)组右侧CST和SQ(异常)组左侧SCP的异常表明,SQ(异常)患者代表具有不同缺陷的亚组。此外,这些结果证明了SCP参与了精神分裂症动作序列的发病机制。