Becker T, Schmidtke A, Stöber G, Franzek E, Teichmann E, Hofmann E
Psychiatrische Klinik und Poliklinik, Universität Würzburg.
Nervenarzt. 1994 Mar;65(3):191-7.
In a sample of 130 patients who had undergone MRI (transverse T2-weighted SE sequence) patchy white matter lesions (WML) were documented according to number and spatial distribution in the brain. Ventricle-to-Brain Ratio (VBR) was determined. Configural frequency analysis led to delineation of four patient groups on the basis of WML location: 1. no WML (n = 35), 2. right frontal-temporal WML (n = 23), 3. bifrontal WML (n = 12), 4. WML in all/all but one brain region (n = 16). Psychopathological symptoms reported in the course of a maximum of 3 years were documented by chart review. In the 'pervasive WML' group psychopathological items characteristic of organic brain syndromes prevailed, mean VBR exceeded values in all other groups (ANOVA, p < 0.001). WML spatial distribution accounted for 10.2% of total psychopathological variance. Patient age, but not VBR, had a significant impact on symptom profile (MANCO-VA). When the 'pervasive WML' group was excluded, the finding of a significant effect of WML location on psychopathological symptom profiles was robust. Bifrontal WML were associated with thought incoherence, right frontal-temporal WML with affective symptoms. Findings support an impact of spatial distribution of unspecific WML on psychopathological symptoms in psychiatric patients.
在130例接受过MRI（横向T2加权SE序列）检查的患者样本中，根据脑部白质病变（WML）的数量和空间分布记录了斑片状白质病变情况。测定了脑室脑比（VBR）。构型频率分析根据WML的位置划分出四个患者组：1. 无WML（n = 35），2. 右侧额颞叶WML（n = 23），3. 双侧额叶WML（n = 12），4. 所有/除一个脑区外所有脑区有WML（n = 16）。通过病历审查记录了最长3年病程中报告的精神病理症状。在“广泛WML”组中，以器质性脑综合征为特征的精神病理项目占主导，平均VBR超过所有其他组的值（方差分析，p < 0.001）。WML的空间分布占精神病理总方差的10.2%。患者年龄而非VBR对症状特征有显著影响（协方差分析）。排除“广泛WML”组后，WML位置对精神病理症状特征有显著影响这一发现仍然成立。双侧额叶WML与思维不连贯有关，右侧额颞叶WML与情感症状有关。研究结果支持非特异性WML的空间分布对精神科患者精神病理症状有影响。
