Lei Wei, Li Na, Deng Wei, Li Mingli, Huang Chaohua, Ma Xiaohong, Wang Qiang, Guo Wanjun, Li Yinfei, Jiang Lijun, Zhou Yi, Hu Xun, McAlonan Grainne Mary, Li Tao
The Mental Health Center &Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China.
Department of Radiology, Hospital of Chengdu Office of People's Government of Tibetan autonomous Region, Branch Hospital of West China Hospital, Sichuan University, Chengdu City, Sichuan Province, China.
Sci Rep. 2015 Aug 10;5:12994. doi: 10.1038/srep12994.
Categorizing 'deficit schizophrenia' (DS) as distinct from 'non-deficit' schizophrenia (NDS) may help reduce heterogeneity within schizophrenia. However, it is unknown if DS has a discrete white matter signature. Here we used MRI to compare white matter volume (voxel-based morphometry) and microstructural integrity (fractional anisotropy, FA) in first-episode treatment-naïve patients with DS and NDS and their unaffected relatives to control groups of similar age. We found that white matter disruption was prominent in DS compared to controls; the DS group had lower volumes in the cerebellum, bilateral extra-nuclear and bilateral frontoparietal regions, and lower FA in the body of corpus callosum, posterior superior longitudinal fasciculus and uncinate fasciculus. The DS group also had lower volume in bilateral extra-nuclear regions compared to NDS, and the volume of these clusters was negatively correlated with deficit symptom ratings. NDS patients however, had no significant volume alterations and limited disruption of microstructural integrity compared to controls. Finally, first-degree relatives of those with DS shared volume abnormalities in right extra-nuclear white matter. Thus, white matter pathology in schizophrenia is most evident in the deficit condition, and lower extra-nuclear white matter volumes in both DS patients and their relatives may represent a brain structural 'endophenotype' for DS.
将“缺陷型精神分裂症”（DS）与“非缺陷型”精神分裂症（NDS）区分开来，可能有助于减少精神分裂症内部的异质性。然而，目前尚不清楚DS是否具有独特的白质特征。在此，我们使用磁共振成像（MRI）来比较首次发作、未接受过治疗的DS患者和NDS患者及其未患病亲属与年龄相仿的对照组的白质体积（基于体素的形态学测量）和微观结构完整性（分数各向异性，FA）。我们发现，与对照组相比，DS患者的白质破坏较为显著；DS组在小脑、双侧核外区域和双侧额顶叶区域的体积较小，胼胝体、后上纵束和钩束的FA较低。与NDS组相比，DS组在双侧核外区域的体积也较小，这些区域的体积与缺陷症状评分呈负相关。然而，与对照组相比，NDS患者没有明显的体积改变，微观结构完整性的破坏也有限。最后，DS患者的一级亲属在右侧核外白质中也存在体积异常。因此，精神分裂症中的白质病理在缺陷型状态下最为明显，DS患者及其亲属较低的核外白质体积可能代表了DS的一种脑结构“内表型”。
