Fitzsimmons Jennifer, Schneiderman Jason S, Whitford Thomas J, Swisher Tali, Niznikiewicz Margaret A, Pelavin Paula E, Terry Douglas P, Mesholam-Gately Raquelle I, Seidman Larry J, Goldstein Jill M, Kubicki Marek
Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women׳s Hospital, Harvard Medical School, Boston, MA, USA.
Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women׳s Hospital, Harvard Medical School, Boston, MA, USA; Wyle Integrated Science and Engineering Group, Houston, TX, USA.
Psychiatry Res. 2014 Nov 30;224(2):124-32. doi: 10.1016/j.pscychresns.2014.08.002. Epub 2014 Aug 15.
The goal of this study was to assess integrity of the cingulum bundle in patients diagnosed with first episode schizophrenia, chronic schizophrenia, and matched controls as well as to determine the relationship between diffusion measures of cingulum bundle integrity and severity of patients' delusions of reference. Participants, who comprised 18 first episode patients, 20 chronic patients, and two groups of matched controls (20 subjects in each), underwent 3 T MRI diffusion tensor imaging. Patients diagnosed with schizophrenia (chronic+first episode) showed decreased fractional anisotropy in the right cingulum bundle compared with controls. First episode patients exhibited higher trace bilaterally, compared with matched controls, and on the left compared with chronic patients. Axial diffusivity was increased in first episode patients, bilaterally, compared with matched controls and chronic patients. Radial diffusivity was also higher, bilaterally, in first episode patients compared with matched controls, and on the right compared with chronic patients. Trace diffusity and radial diffusivity in first episode patients were significantly correlated with increased severity of delusions of reference. Given that the abnormalities were present only in first episode patients and were not observed in chronic cases, it appears that they normalize over time. These abnormalities in first episode patients involved diffusivity measures in all directions (trace, radial and axial), suggesting a likely acute, partially reversible process in which there is an increase in brain water content, i.e., swelling, edema, or inflammation, that may reflect an early neuroinflammatory response in first episode patients.
本研究的目的是评估首次发作的精神分裂症患者、慢性精神分裂症患者及相匹配的对照组的扣带束完整性，并确定扣带束完整性的扩散测量值与患者牵连观念严重程度之间的关系。研究参与者包括18例首次发作患者、20例慢性患者以及两组相匹配的对照组（每组20名受试者），他们均接受了3T磁共振成像扩散张量成像检查。与对照组相比，被诊断为精神分裂症（慢性+首次发作）的患者右侧扣带束的各向异性分数降低。与相匹配的对照组相比，首次发作患者双侧以及与慢性患者相比左侧的迹值更高。与相匹配的对照组和慢性患者相比，首次发作患者双侧的轴向扩散率增加。与相匹配的对照组相比，首次发作患者双侧的径向扩散率也更高，且与慢性患者相比右侧的径向扩散率更高。首次发作患者的迹扩散率和径向扩散率与牵连观念严重程度增加显著相关。鉴于这些异常仅在首次发作患者中出现，而在慢性病例中未观察到，似乎它们会随着时间推移而恢复正常。首次发作患者的这些异常涉及所有方向的扩散测量值（迹、径向和轴向），表明这可能是一个急性、部分可逆的过程，其中脑含水量增加，即肿胀、水肿或炎症，这可能反映了首次发作患者早期的神经炎症反应。
