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首发精神分裂症伴幻听患者脑白质完整性:基于图谱的弥散张量成像分析。

The integrity of the white matter in first-episode schizophrenia patients with auditory verbal hallucinations: An atlas-based DTI analysis.

机构信息

School of Public Health, Central South University, Changsha, China; Department of Communicable Disease Prevention and Management, Centers for Disease Control and Prevention(CDC) of Changsha City, Changsha, China.

Department of Geriatrics, The First Affiliated Hospital of Yunnan University of Chinese Medicine, Kunming, China.

出版信息

Psychiatry Res Neuroimaging. 2021 Sep 30;315:111328. doi: 10.1016/j.pscychresns.2021.111328. Epub 2021 Jul 4.

Abstract

Auditory verbal hallucination (AVH) is one of the most remarkable symptoms of schizophrenia, with great impact on patients' lives and unclear pathogenesis. Neuroimaging studies have indicated that the development of AVHs is associated with white matter alteration, however, there are still inconsistencies in specific findings across previous investigations. The present study aimed to investigate the characteristics of the microstructural integrity of white matter (WM) in first-episode schizophrenia patients who experience auditory hallucinations. Atlas-based Diffusion Tensor Imaging (DTI) analysis was performed to evaluate the white matter integrity in 37 first-episode schizophrenia patients with AVH, 60 schizophrenia patients without AVH, and 50 healthy controls. Compared with the healthy controls group, AVH showed decreased mean fractional anisotropy (FA) in the genu and body of corpus callosum, right posterior corona radiata, left superior corona radiata, left external capsule, right superior fronto-occipital fasciculus, and higher mean diffusivity (MD) in genu of corpus callosum and left fornix and stria terminalis; whereas the nAVH group showed a much more significant reduction of FA and increased MD in broader brain regions. In addition, a significant positive correlation between FA and the severity of AVHs was observed in right posterior corona radiate. These observations collectively demonstrated that a certain degree of preserved fronto-temporal and interhemispheric connectivity in the early stage of schizophrenia might be associated with the brain capability to generate AVHs.

摘要

听觉言语幻觉(AVH)是精神分裂症最显著的症状之一,对患者的生活有很大影响,但发病机制尚不清楚。神经影像学研究表明,AVH 的发展与白质改变有关,但在之前的研究中,具体发现仍存在不一致。本研究旨在探讨首次出现听觉幻觉的精神分裂症患者白质(WM)微观结构完整性的特征。采用基于图谱的弥散张量成像(DTI)分析,对 37 例出现听觉幻觉的首发精神分裂症患者、60 例无听觉幻觉的精神分裂症患者和 50 名健康对照者的 WM 完整性进行评估。与健康对照组相比,AVH 组患者胼胝体膝部和体部、右侧后放射冠、左侧上放射冠、左侧外囊、右侧额枕上束和左侧穹窿及终纹的平均各向异性分数(FA)降低,而胼胝体膝部和左侧穹窿及终纹的平均弥散系数(MD)升高;而 nAVH 组患者在更广泛的脑区中 FA 显著降低,MD 显著升高。此外,右侧后放射冠的 FA 与 AVH 严重程度呈显著正相关。这些观察结果共同表明,精神分裂症早期存在一定程度的额颞和半球间连接保留,可能与大脑产生 AVH 的能力有关。

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