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精神分裂症的白质完整性与症状维度:一项扩散张量成像研究。

White matter integrity and symptom dimensions of schizophrenia: A diffusion tensor imaging study.

作者信息

Bopp Miriam H A, Zöllner Rebecca, Jansen Andreas, Dietsche Bruno, Krug Axel, Kircher Tilo T J

机构信息

Department of Psychiatry and Psychotherapy, University of Marburg, Rudolf-Bultmann-Strasse 8, 35039 Marburg, Germany; Department of Neurosurgery, University of Marburg, Baldingerstrasse, 35043 Marburg, Germany; International Clinical Research Center, St. Anne's University Hospital, Pekarska 53, 65691 Brno, Czech Republic.

Department of Psychiatry and Psychotherapy, University of Marburg, Rudolf-Bultmann-Strasse 8, 35039 Marburg, Germany.

出版信息

Schizophr Res. 2017 Jun;184:59-68. doi: 10.1016/j.schres.2016.11.045. Epub 2016 Dec 21.

Abstract

Impaired fiber bundle connectivity between brain regions is a key neuropathological finding in schizophrenia. Symptom dimensions in schizophrenia can be clustered into factor models. Single syndromes have been related to grey and white matter brain structure alterations. We associated all core syndromes of schizophrenia in a single patient group with changes in white matter integrity. Diffusion weighted images (3T MRI) and SAPS/SANS scores were measured in 26 male patients and 26 healthy controls. First, group differences in fractional anisotropy (FA) were calculated with TBSS. Second, core symptom dimensions of schizophrenia were correlated with FA within these altered tracts. We found differences between groups in nine white matter tracts. Hallucinations were positively correlated with FA in the left uncinate fasciculus and left corticospinal tract. Ego-disturbances (passivity phenomena) showed a positive correlation with FA in the right anterior thalamic radiation. Positive formal thought disorders (FTD) corresponded negatively with FA in the right cingulum bundle. Negative symptoms were positively associated with the right anterior thalamic radiation and negatively with the right ventral cingulum bundle. For the first time, we analyzed the whole range of psychopathological factors in one schizophrenia patient group. We could validate our novel results for positive FTD and passivity phenomena by replicating findings for hallucinations and negative symptoms. Only those brain circuits which are most vulnerable at a given time during neurodevelopment are affected by a particular pathological impact (genetic, environmental). This scenario could explain the predominance of particular psychopathological syndromes related to specific white matter anomalies.

摘要

脑区之间纤维束连接受损是精神分裂症的关键神经病理学发现。精神分裂症的症状维度可聚类为因子模型。单一综合征与灰质和白质脑结构改变有关。我们将单一患者组中精神分裂症的所有核心综合征与白质完整性变化相关联。对26名男性患者和26名健康对照者进行了扩散加权成像(3T磁共振成像)和SAPS/SANS评分测量。首先,用基于体素的空间统计分析(TBSS)计算各向异性分数(FA)的组间差异。其次,在这些改变的脑区中,将精神分裂症的核心症状维度与FA进行相关性分析。我们发现九种白质束存在组间差异。幻觉与左侧钩束和左侧皮质脊髓束的FA呈正相关。自我障碍(被动现象)与右侧丘脑前辐射的FA呈正相关。阳性形式思维障碍(FTD)与右侧扣带束的FA呈负相关。阴性症状与右侧丘脑前辐射呈正相关,与右侧腹侧扣带束呈负相关。我们首次在一个精神分裂症患者组中分析了整个范围的精神病理因素。我们可以通过复制幻觉和阴性症状的研究结果来验证我们关于阳性FTD和被动现象的新结果。只有那些在神经发育过程中特定时间最易受损的脑回路才会受到特定病理影响(遗传、环境)的影响。这种情况可以解释与特定白质异常相关的特定精神病理综合征的优势。

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