首发精神病患者听觉幻觉中布罗卡氏-韦尼克氏-苍白球“霍夫曼幻觉回路”和听觉胼胝体纤维的白质微观结构异常。
White Matter Microstructural Abnormalities in the Broca's-Wernicke's-Putamen "Hoffman Hallucination Circuit" and Auditory Transcallosal Fibers in First-Episode Psychosis With Auditory Hallucinations.
机构信息
Clinical Neurophysiology Research Laboratory, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, PA.
Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA.
出版信息
Schizophr Bull. 2021 Jan 23;47(1):149-159. doi: 10.1093/schbul/sbaa105.
BACKGROUND
Functional connectivity abnormalities between Broca's and Wernicke's areas and the putamen revealed by functional magnetic resonance imaging (fMRI) are related to auditory hallucinations (AH). In long-term schizophrenia, reduced white matter structural integrity revealed by diffusion imaging in left arcuate fasciculus (connecting Broca's and Wernicke's areas) is likely related to AH. The structural integrity of connections with putamen and their relation to AH are unknown. Little is known about this relationship in first-episode psychosis (FEP), although auditory transcallosal connections were reported to play a role. White matter in the Broca's-Wernicke's-putamen language-related circuit and auditory transcallosal fibers was examined to investigate associations with AH in FEP.
METHODS
White matter connectivity was measured in 40 FEP and 32 matched HC using generalized fractional anisotropy (gFA) derived from diffusion spectrum imaging (DSI).
RESULTS
FEP and HC did not differ in gFA in any fiber bundle. In FEP, AH severity was significantly inversely related to gFA in auditory transcallosal fibers and left arcuate fasciculus. Although the right hemisphere arcuate fasciculus-AH association did not attain significance, the left and right arcuate fasciculus associations were not significantly different.
CONCLUSIONS
Despite overall normal gFA in FEP, AH severity was significantly related to gFA in transcallosal auditory fibers and the left hemisphere connection between Broca's and Wernicke's areas. Other bilateral tracts' gFA were weakly associated with AH. At the first psychotic episode, AH are more robustly associated with left hemisphere arcuate fasciculus and interhemispheric auditory fibers microstructural deficits, likely reflecting mistiming of information flow between language-related cortical centers.
背景
功能磁共振成像（fMRI）显示的布罗卡区和韦尼克区与壳核之间的功能连接异常与听觉幻觉（AH）有关。在长期精神分裂症中，扩散成像显示左侧弓状束（连接布罗卡区和韦尼克区）的白质结构完整性降低，这可能与 AH 有关。与壳核的连接结构完整性及其与 AH 的关系尚不清楚。虽然据报道听觉胼胝体连接在首发精神病（FEP）中起作用，但对这种关系知之甚少。白质在布罗卡-韦尼克-壳核语言相关回路和听觉胼胝体纤维中进行了检查，以研究 FEP 中与 AH 的关系。
方法
使用来自扩散谱成像（DSI）的广义各向异性分数（gFA），在 40 名 FEP 和 32 名匹配的 HC 中测量白质连接。
结果
FEP 和 HC 在任何纤维束中的 gFA 均无差异。在 FEP 中，AH 严重程度与听觉胼胝体纤维和左侧弓状束的 gFA 呈显著负相关。尽管右侧半球弓状束与 AH 的关联未达到显著性，但左侧和右侧弓状束的关联无显著性差异。
结论
尽管 FEP 患者的总体 gFA 正常，但 AH 严重程度与胼胝体听觉纤维和布罗卡区与韦尼克区之间的左侧半球连接的 gFA 显著相关。其他双侧束的 gFA 与 AH 呈弱相关。在首次精神病发作时，AH 与左侧半球弓状束和半球间听觉纤维的微观结构缺陷更密切相关，这可能反映了语言相关皮质中枢之间信息流的时间错误。
Zotero 插件