CAJ | 학술논문

目的应用基于体素的脑形态测量学(Voxel-based Morphometric,VBM)法,比较缺陷型与非缺陷型精神分裂症患者大脑灰质结构损害的差异.方法采用GE Signa TwinSpeed 1.5T超导型MRI成像系统,对缺陷型精神分裂症(N=10)、非缺陷型精神分裂症(n=11)及正常对照(n=15)进行全脑扫描,获取脑解剖结构MR T1图像.随后基于Matlab7.6及SPM5进行优化的VBM数据分析,再进行成组t检验.结果与正常对照相比,非缺陷型患者的额、顶、颞、枕叶及基底节均有灰质体积下降;而缺陷型患者的灰质下降以广泛及显著的额叶损伤为特征,包括左额内侧回、双侧额下回、左侧额中回及左侧眶回等多个额叶区域,另外还涉及左颞中回、右颞上回以及右侧脑岛(Cluster≥30 mm3,P<0.01).两种亚型患者的比较显示,缺陷型患者在左额内侧回、双侧额下回、右中央前回以及右颞上回等脑区的灰质体积均低于非缺陷型患者(Cluster≥30 mm3,P<0.01).结论精神分裂症的结构异质性可能是在共有额叶-颞叶脑区的灰质结构改变的基础上,缺陷型与非缺陷型的患者各有其特定的灰质下降模式.
목적 응용기우체소적뇌형태측량학(Voxel-based Morphometric,VBM)법,비교결함형여비결함형정신분렬증환자대뇌회질결구손해적차이.방법 채용GE Signa TwinSpeed 1.5T초도형MRI성상계통,대결함형정신분렬증(N=10)、비결함형정신분렬증(n=11)급정상대조(n=15)진행전뇌소묘,획취뇌해부결구MR T1도상.수후기우Matlab7.6급SPM5진행우화적VBM수거분석,재진행성조t검험.결과 여정상대조상비,비결함형환자적액、정、섭、침협급기저절균유회질체적하강;이결함형환자적회질하강이엄범급현저적액협손상위특정,포괄좌액내측회、쌍측액하회、좌측액중회급좌측광회등다개액협구역,령외환섭급좌섭중회、우섭상회이급우측뇌도(Cluster≥30 mm3,P<0.01).량충아형환자적비교현시,결함형환자재좌액내측회、쌍측액하회、우중앙전회이급우섭상회등뇌구적회질체적균저우비결함형환자(Cluster≥30 mm3,P<0.01).결론 정신분렬증적결구이질성가능시재공유액협-섭협뇌구적회질결구개변적기출상,결함형여비결함형적환자각유기특정적회질하강모식.
Objective To examine the differences in the structure of brain white matter among deficit schizophrenia, nondeficit schizophrenia and healthy controls by using voxel-based morphometry (VBM). Methods Ten deficit schizophrenic patients, eleven nondeficit patients and fifteen healthy comparison subjects participated in the study. All the subjects were scanned by GE Twin Speed 1.5T MRI system. Whole brain, voxel-wise analyses of regional white matter volume were conducted by the VBM toolbox on the Matlab7.6 and SPM5. t -test was then used for the comparison between groups. Results Compared to the healthy controls, nondeficit schizophrenic patients significantly decreased the density of gray matter in the frontal, parietal, temporal, occipital lobe and basal ganglia , while the deficit patients showed the characteristically broad and significant decreasion in the frontal lobe, including left medial frontal gyrus, bilateral inferior frontal gyrus, left middle frontal gyrus, and left orbital gyrus (Cluster ≥ 30 mm3, P<0.01). Moreover, deficit patients showed the decreasion in the temporal cortex and the limbic lobe (right insula). Relative to the nondeficit schizophrenic patients, deficit patients had significant regional gray matter decreases in the left medial frontal gyrus, bilateral inferior frontal gyrus, right precentral gyrus, and right superior temporal gyrus (Cluster ≥ 30 mm3, P<0.01). Conclusion Structural heterogeneity in schizophrenia may relate to specific patterns of gray matter density reductions in deficit and nondeficit patient. However the two subtype of schizophremia patients share a common prefrontal-temperal pattern of structural brain alterations.