Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Germany.
Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Germany; Department of Psychiatry, Psychotherapy and Psychosomatics, Saarland University, Homburg, Germany.
Prog Neuropsychopharmacol Biol Psychiatry. 2015 Jul 3;60:18-25. doi: 10.1016/j.pnpbp.2015.01.011. Epub 2015 Jan 29.
Previous structural neuroimaging studies linked cerebellar deficits to neurological soft signs (NSS) in schizophrenia. However, no studies employed a methodology specifically designed to assess cerebellar morphology. In this study, we evaluated the relationship between NSS levels and abnormalities of the human cerebellum in patients with recent-onset schizophrenia and healthy individuals using an exclusive cerebellar atlas.
A group of 26 patients with recent-onset schizophrenia and 26 healthy controls were included. All participants underwent a high-resolution T1-weighted MRI scan on a 3 Tesla scanner. We used a voxel-based morphometry (VBM) approach utilizing the Spatially Unbiased Infratentorial (SUIT) toolbox to provide an optimized and fine-grained exploration of cerebellar structural alterations associated with NSS.
Compared with healthy controls, patients had significantly smaller cerebellar volumes for both hemispheres. In the patients' group, we identified a significant negative correlation between NSS levels and gray matter volume in the left lobule VI and the right lobule VIIa, corrected for multiple comparisons. Further, NSS performance was significantly associated with white matter volume in the left midbrain and corpus medullare and the right lobule VIIa. In contrast, no significant associations between NSS scores and cerebellar subregions in healthy subjects arose.
Our results demonstrate the benefits of SUIT when investigating cerebellar correlates of NSS. These results support the view that distinct parts of sensorimotor and cognitive cerebellum play an important role in the pathogenesis of NSS in schizophrenia.
先前的结构神经影像学研究将小脑缺陷与精神分裂症的神经学软体征（NSS）联系起来。然而，没有研究采用专门设计的方法来评估小脑形态。在这项研究中，我们使用专门的小脑图谱，评估了首发精神分裂症患者和健康个体中 NSS 水平与小脑异常之间的关系。
纳入了 26 名首发精神分裂症患者和 26 名健康对照者。所有参与者均在 3 Tesla 扫描仪上接受了高分辨率 T1 加权 MRI 扫描。我们使用基于体素的形态测量学（VBM）方法，利用 Spatially Unbiased Infratentorial（SUIT）工具包，对与 NSS 相关的小脑结构改变进行优化和精细探索。
与健康对照组相比，患者双侧小脑体积明显较小。在患者组中，我们发现 NSS 水平与左侧 VI 小叶和右侧 VIIa 小叶灰质体积之间存在显著负相关，经多重比较校正。此外，NSS 表现与左侧中脑和髓质以及右侧 VIIa 小叶的白质体积显著相关。相比之下，在健康受试者中，NSS 评分与小脑亚区之间没有显著相关性。
我们的研究结果表明，在研究 NSS 的小脑相关性时，SUIT 具有优势。这些结果支持这样一种观点，即感觉运动和认知小脑的不同部分在精神分裂症 NSS 的发病机制中起着重要作用。
