Whitford Thomas J, Kubicki Marek, Pelavin Paula E, Lucia Diandra, Schneiderman Jason S, Pantelis Christos, McCarley Robert W, Shenton Martha E
School of Psychology, UNSW Australia (The University of New South Wales), Sydney, NSW, Australia; Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia.
Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Schizophr Res. 2015 Jan;161(1):36-41. doi: 10.1016/j.schres.2014.08.033. Epub 2014 Oct 11.
Delusions of control are among the most distinctive and characteristic symptoms of schizophrenia. Several theories have been proposed that implicate aberrant communication between spatially disparate brain regions in the etiology of this symptom. Given that white matter fasciculi represent the anatomical infrastructure for long-distance communication in the brain, the present study investigated whether delusions of control were associated with structural abnormalities in four major white matter fasciculi.
Ten schizophrenia patients with current delusions of control, 13 patients with no clinical history of delusions of control, and 12 healthy controls underwent a Diffusion-Tensor Imaging (DTI) scan. Deterministic tractography was used to extract the corpus callosum, superior longitudinal fasciculus, arcuate fasciculus, and cingulum bundle. The structural integrity of these four fasciculi was quantified with fractional anisotropy (FA) and compared between groups.
The patients with delusions of control exhibited significantly lower FA in all four fasciculi, relative to the healthy controls. Furthermore, the patients with delusions of control also exhibited significantly lower FA in the cingulum bundle relative to patients without a history of this symptom, and this difference remained significant when controlling for between-group differences in global SAPS score and medication dosage.
The results suggest that structural damage to the cingulum bundle may be involved in the etiology of delusions of control, possibly because of its role in connecting the action initiation areas of the premotor cortex with the cingulate gyrus.
控制妄想是精神分裂症最具独特性和特征性的症状之一。已经提出了几种理论，认为这种症状的病因与空间上不同的脑区之间的异常通讯有关。鉴于白质束代表了大脑中长距离通讯的解剖学基础结构，本研究调查了控制妄想是否与四个主要白质束的结构异常有关。
10名目前存在控制妄想的精神分裂症患者、13名无控制妄想临床病史的患者以及12名健康对照者接受了扩散张量成像（DTI）扫描。使用确定性纤维束成像来提取胼胝体、上纵束、弓状束和扣带束。用分数各向异性（FA）对这四个纤维束的结构完整性进行量化，并在组间进行比较。
与健康对照者相比，存在控制妄想的患者在所有四个纤维束中的FA均显著降低。此外，与无此症状病史的患者相比，存在控制妄想的患者在扣带束中的FA也显著降低，并且在控制了组间总体简明精神病评定量表（SAPS）评分和药物剂量差异后，这种差异仍然显著。
结果表明，扣带束的结构损伤可能参与了控制妄想的病因，可能是因为其在将运动前皮质的动作起始区域与扣带回连接方面的作用。
