Zeng Jiaxin, Zhang Wenjing, Fu Gui, Xiao Yuan, Tang Biqiu, Yao Li, Lu Su
Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, P.R.China.
Sheng Wu Yi Xue Gong Cheng Xue Za Zhi. 2020 Jun 25;37(3):480-486. doi: 10.7507/1001-5515.201905062.
The study aims to investigate whether there is difference in pre-treatment white matter parameters in treatment-resistant and treatment-responsive schizophrenia. Diffusion tensor imaging (DTI) was acquired from 60 first-episode drug-naïve schizophrenia (39 treatment-responsive and 21 treatment-resistant schizophrenia patients) and 69 age- and gender-matched healthy controls. Imaging data was preprocessed via FSL software, then diffusion parameters including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD) were extracted. Besides, structural network matrix was constructed based on deterministic fiber tracking. The differences of diffusion parameters and topology attributes between three groups were analyzed using analysis of variance (ANOVA). Compared with healthy controls, treatment-responsive schizophrenia showed altered white matter mainly in anterior thalamus radiation, splenium of corpus callosum, cingulum bundle as well as superior longitudinal fasciculus. While treatment-resistant schizophrenia patients showed white matter abnormalities in anterior thalamus radiation, cingulum bundle, fornix and pontine crossing tract relative to healthy controls. Treatment-resistant schizophrenia showed more severe white matter abnormalities in anterior thalamus radiation compared with treatment-responsive patients. There was no significant difference in white matter network topological attributes among the three groups. The performance of support vector machine (SVM) showed accuracy of 63.37% in separating the two patient subgroups ( = 0.04). In this study, we showed different patterns of white matter alterations in treatment-responsive and treatment-resistant schizophrenia compared with healthy controls before treatment, which may help guiding patient identification, targeted treatment and prognosis improvement at baseline drug-naïve state.
该研究旨在调查难治性和反应性精神分裂症患者治疗前白质参数是否存在差异。对60例首发未用药的精神分裂症患者（39例反应性精神分裂症患者和21例难治性精神分裂症患者）以及69名年龄和性别匹配的健康对照者进行了扩散张量成像（DTI）检查。成像数据通过FSL软件进行预处理，然后提取包括分数各向异性（FA）、平均扩散率（MD）、轴向扩散率（AD）和径向扩散率（RD）在内的扩散参数。此外，基于确定性纤维追踪构建了结构网络矩阵。使用方差分析（ANOVA）分析三组之间扩散参数和拓扑属性的差异。与健康对照者相比，反应性精神分裂症患者的白质改变主要见于丘脑前辐射、胼胝体压部、扣带束以及上纵束。而难治性精神分裂症患者相对于健康对照者，在前丘脑辐射、扣带束、穹窿和脑桥交叉束出现白质异常。与反应性患者相比，难治性精神分裂症患者在前丘脑辐射中的白质异常更为严重。三组之间白质网络拓扑属性无显著差异。支持向量机（SVM）在区分两个患者亚组时的准确率为63.37%（P = 0.04）。在本研究中，我们发现与治疗前的健康对照者相比，反应性和难治性精神分裂症患者存在不同模式的白质改变，这可能有助于在基线未用药状态下指导患者识别、靶向治疗和改善预后。
