Xia Y H, Pei K Y, Li Y L, Li Y D, Xiao S, Guo S Q
Department of Child and Adolescent Psychiatry, the Second Affiliated Hospital of Xinxiang Medical University, Xinxiang Key Laboratory of Child and Adolescent Psychiatry, Xinxiang453002, China.
Department of Neurology, the Third Affiliated Hospital of Xinxiang Medical University, Xinxiang453002, China.
Zhonghua Yi Xue Za Zhi. 2024 Dec 3;104(45):4132-4139. doi: 10.3760/cma.j.cn112137-20240712-01596.
To analyze the relationship of gray matter volume and cortical thickness of auditory verbal hallucination in first-episode childhood-onset schizophrenia(COS). Sixty cases of first-episode childhood-onset schizophrenia who were treated in the inpatient department of the Second Affiliated Hospital of Xinxiang Medical University from October 2020 to February 2024 were collected(case group).Thirty-two healthy students from a primary and secondary school in Xinxiang city were the control group. According to the score of "auditory hallucination" on the positive symptoms scale (SAPS), the patients were divided into the non-auditory hallucination group(nAVH) (=16, score 0-1) and the auditory hallucination group (AVH)(=38, score 2-5). The severity of psychiatric symptoms of patients was evaluated using Positive And Negative Syndrome Scale (PANSS). Resting-state MRI data was scanned for all subjects. REST software and FreeSurfer software was used for covariance analysis of gray matter volume and cortical thickness.Age and gender as covariates. Finally, 54 case groups were included, including 16 cases in the non-auditory hallucination group, there were 8 males and 8 females, with an age of (12.9±1.7) years; in the auditory hallucination group, there were 16 males and 22 females, with an age of (13.1±1.5) years.There were Control group of 27 cases, 12 males, 15 females, with an age of (12.2±1.5) years. In the covariance analysis of gray matter volume showed that the brain regions with differences were mainly located in the left parahippocampal gyrus, cingulate gyrus, superior temporal gyrus, inferior frontal gyrus, superior temporal gyrus, occipital lobe, precentral gyrus, inferior parietal gyrus; Right superior frontal gyrus, lingual gyrus, fusiform gyrus, transverse temporal gyrus, inferior temporal gyrus, superior temporal gyrus(<0.05, FDR correction).Post hoc tests found that compared with the control group, the cerebral areas with decreased gray matter volume in the AVH group were mainly located in the left superior temporal gyrus, hippocampus, cingulate gyrus, middle temporal gyrus, insula, inferior frontal gyrus;right superior temporal gyrus, superior frontal gyrus, supramargal gyrus and transverse temporal gyrus(<0.05, FDR correction). In the covariance analysis of Cortical Thickness showed that the brain regions with differences were mainly located in the left inferior parietal gyrus, middle temporal gyrus, anterior central gyrus, supramarginal gyrus, transverse temporal gyrus, Lateral orbitofrontal cortex, insular lobe, anterior cingutate, precuneus, right superior temporal gyrus, cuneiform gyrus, middle frontal gyrus(<0.05, FDR correction).Post hoc tests found that compared with the control group, the cerebral areas with decreased cortical thickness in the the left postcentral gyrus, transverse temporal gyrus, lateral orbitofrontal cortex, superior frontal gyrus, superior temporal gyrus, insular lobe; right cuneiform gyrus, superior temporal gyrus, supramarginal gyrus, middle temporal gyrus.The increased cortical thickness was found in the right anterior cingulate(<0.05,FDR corrected). the nAVH group showed decreased cortical thickness areas mainly located in the left inferior temporal gyrus, inferior parietal gyrus, lateral orbitofrontal cortex, superior frontal gyrus, postcentral gyrus; right cuneiform gyrus, middle temporal gyrus, precentral gyrus. The rest showed no obvious abnormality, and the differences were statistically significant (<0.05, FDR corrected). The decreased gray matter volume and cortical thickness is found in multiple brain regions in with or without auditory verbal hallucination in first-episode childhood-onset schizophrenia. Consequently, abnormal gray matter structure may be associated with the pathogenesis of childhood schizophrenia.The abnormal structure of the left and right superior temporal grrus, right supramarginal gyrus, right anterior cingulate cortex may be related to the mechanism of auditory hallucination.
分析首发儿童期起病精神分裂症（COS）中听觉言语幻觉的灰质体积与皮质厚度的关系。收集2020年10月至2024年2月在新乡医学院第二附属医院住院部治疗的60例首发儿童期起病精神分裂症患者（病例组）。选取新乡市某中小学32名健康学生作为对照组。根据阳性症状量表（SAPS）中“幻听”得分，将患者分为非幻听组（nAVH，n = 16，得分0 - 1）和幻听组（AVH，n = 38，得分2 - 5）。采用阳性与阴性症状量表（PANSS）评估患者精神症状严重程度。对所有受试者进行静息态MRI数据扫描。使用REST软件和FreeSurfer软件对灰质体积和皮质厚度进行协方差分析，以年龄和性别作为协变量。最终纳入病例组54例，其中非幻听组16例，男性8例，女性8例，年龄为（12.9±1.7）岁；幻听组中男性16例，女性22例，年龄为（13.1±1.5）岁。对照组27例，男性12例，女性15例，年龄为（12.2±1.5）岁。灰质体积协方差分析显示，存在差异的脑区主要位于左侧海马旁回、扣带回、颞上回、额下回、颞上回、枕叶、中央前回、顶下小叶；右侧额上回、舌回、梭状回、颞横回、颞下回、颞上回（P<0.05，FDR校正）。事后检验发现，与对照组相比，AVH组灰质体积减小的脑区主要位于左侧颞上回、海马、扣带回、颞中回、岛叶、额下回；右侧颞上回、额上回、缘上回和颞横回（P<0.05，FDR校正）。皮质厚度协方差分析显示，存在差异的脑区主要位于左侧顶下小叶、颞中回、中央前回、缘上回、颞横回、外侧眶额皮质、岛叶、前扣带回、楔前叶、右侧颞上回、楔状回、额中回（P<0.05，FDR校正）。事后检验发现，与对照组相比，左侧中央后回、颞横回、外侧眶额皮质、额上回、颞上回、岛叶皮质厚度减小；右侧楔状回、颞上回、缘上回、颞中回皮质厚度减小。右侧前扣带回皮质厚度增加（P<0.05，FDR校正）。nAVH组皮质厚度减小区域主要位于左侧颞下回、顶下小叶、外侧眶额皮质、额上回、中央后回；右侧楔状回、颞中回、中央前回。其余未见明显异常，差异具有统计学意义（P<0.05，FDR校正）。首发儿童期起病精神分裂症有或无听觉言语幻觉的患者多个脑区存在灰质体积和皮质厚度减小。因此，灰质结构异常可能与儿童精神分裂症的发病机制有关。左右颞上回、右侧缘上回、右侧前扣带回皮质的结构异常可能与幻听机制有关。
