Canu Elisa, Agosta Federica, Filippi Massimo
Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy; Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
Schizophr Res. 2015 Jan;161(1):19-28. doi: 10.1016/j.schres.2014.05.020. Epub 2014 Jun 2.
Schizophrenia has long been hypothesized to result from a disconnection syndrome due to a disruption of the association fibers of the brain. However, only with the advent of in vivo neuroimaging, a formal disconnectivity hypothesis for schizophrenia has been developed. Diffusion tensor MRI, a non-invasive technique which is sensitive to features of tissue microstructure and to the anatomy of the white matter fibers, has gained a crucial role in the field. Here, we provide a state-of-the-art review of structural connectivity abnormalities detected in schizophrenia and discuss the most relevant findings at preclinical, first episode drug-naïve, and chronic stages. Imaging studies showed white matter alterations from the preclinical to the chronic stage of the disease, which involve the corticospinal tracts, interhemispheric connections, long association white matter tracts, cerebello-thalamo-cortical circuit, and limbic system. Such abnormalities were found to be associated with the psychiatric and cognitive manifestations of the disease and to predict, at least partially, the patient clinical evolution and response to treatment.
长期以来，人们一直假设精神分裂症是由于大脑联合纤维中断导致的一种分离综合征所致。然而，直到活体神经成像技术出现，才形成了关于精神分裂症的正式分离假说。扩散张量磁共振成像（Diffusion tensor MRI）是一种对组织微观结构特征和白质纤维解剖结构敏感的非侵入性技术，在该领域发挥了关键作用。在此，我们对精神分裂症中检测到的结构连接异常进行了最新综述，并讨论了临床前、首次发作未用药和慢性阶段最相关的研究结果。影像学研究显示，从疾病的临床前阶段到慢性阶段存在白质改变，这些改变涉及皮质脊髓束、半球间连接、长联合白质束、小脑 - 丘脑 - 皮质回路和边缘系统。发现这些异常与疾病的精神和认知表现相关，并至少部分地预测患者的临床进展和对治疗的反应。
