CAJ | 학술논문

目的探讨成年早期(18 ～ 25岁)首次发病精神分裂症患者脑灰质体积异常区域,并寻找与精神症状相关的灰质体积局部脑区.方法对21例符合美国精神障碍诊断与统计手册第4版成年早期首次发病精神分裂症患者(患者组)和21名与之相匹配的正常对照(对照组)进行全脑磁共振扫描,获取3D脑结构图像,然后使用优化的基于体素形态学分析法进行数据分析并比较2组脑灰质体积差异；使用阳性和阴性症状量表(PANSS)进行精神症状严重程度的评定,并对患者灰质体积局部脑区与精神症状进行相关分析.结果与对照组比较,患者组左侧眶回(t=4.88,P＜0.001)、左侧额中回(t=4.50,P＜0.001)、左侧颞中回(t=3.95,P＜0.001)、右侧颞中回(t=3.92,P＜0.001)、左侧顶上小叶(t=3.71,P＜0.001)、左侧顶下小叶(=3.93,P＜0.001)及右侧舌回/楔叶(t=3.65,P＜0.001)脑区灰质体积减少；患者组PANSS总分与右侧顶上小叶正相关,与左侧桥脑/中脑负相关；阳性症状分与右侧顶下小叶负相关；阴性症状分与右侧顶上小叶、双侧楔前叶正相关,与左侧桥脑/中脑负相关；一般精神症状分与右侧颞下回、右侧顶下小叶、左侧桥脑/中脑负相关.结论成年早期首次发病精神分裂症患者存在多个脑区灰质体积异常,且有多个脑区的灰质体积与患者精神症状严重程度相关.
목적 탐토성년조기(18 ～ 25세)수차발병정신분렬증환자뇌회질체적이상구역,병심조여정신증상상관적회질체적국부뇌구.방법 대21례부합미국정신장애진단여통계수책제4판성년조기수차발병정신분렬증환자(환자조)화21명여지상필배적정상대조(대조조)진행전뇌자공진소묘,획취3D뇌결구도상,연후사용우화적기우체소형태학분석법진행수거분석병비교2조뇌회질체적차이；사용양성화음성증상량표(PANSS)진행정신증상엄중정도적평정,병대환자회질체적국부뇌구여정신증상진행상관분석.결과 여대조조비교,환자조좌측광회(t=4.88,P＜0.001)、좌측액중회(t=4.50,P＜0.001)、좌측섭중회(t=3.95,P＜0.001)、우측섭중회(t=3.92,P＜0.001)、좌측정상소협(t=3.71,P＜0.001)、좌측정하소협(=3.93,P＜0.001)급우측설회/설협(t=3.65,P＜0.001)뇌구회질체적감소；환자조PANSS총분여우측정상소협정상관,여좌측교뇌/중뇌부상관；양성증상분여우측정하소협부상관；음성증상분여우측정상소협、쌍측설전협정상관,여좌측교뇌/중뇌부상관；일반정신증상분여우측섭하회、우측정하소협、좌측교뇌/중뇌부상관.결론 성년조기수차발병정신분렬증환자존재다개뇌구회질체적이상,차유다개뇌구적회질체적여환자정신증상엄중정도상관.
Objective To investigate the grey matter volume in patients with early adulthood episode (18-25 ages) schizophrenia and the correlations between regional volume and symptom severity.Methods Twenty-one schizophrenia patients with early adulthood episode and twenty-one normal controls matched with age,sex and education were recruited.The diagnosis of schizophrenia was made according to the Diagnostic and Statistical Manual of Mental Disorder the Fourth Edition (DSM-Ⅳ) criteria.Each participant received whole brain MRI scans,then the 3D brain structural MRI images were obtained.The grey matter volume difference between patients and controls was analyzed by using the optimized voxelbased morphometry method (VBM).Symptom severity were assessed using the Positive and Negative Syndrome Scale (PANSS),and the correlation with the grey matter volume were analyzed in the patients.Results Compared to the normal controls,the patients had multiple brain areas abnormal volume.It showed significant decreased grey matter volume in the left orbital gyrus (t =4.88,P ＜ 0.001),left middle frontal gyrus (t =4.50,P ＜ 0.001),left middle teporal gyrus (t =3.95,P ＜ 0.001),right middle temporal gyrus (t =3.92,P ＜ 0.001),left superior parietal lobule(t =3.71,P ＜ 0.001),left inferior parietal lobule (t =3.93,P ＜ 0.001) and right lingual gyrus/cuneus(t =3.65,P ＜ 0.001).Within the patient group,total score of PANSS was positively correlated with grey matter volume of the right superior parietal lobule,but negatively correlated with the left pons/midbrain; and the positive symptom score was negatively related to grey matter volume of the right inferior parietal lobule; and the negative symptom score was positively correlated with grey matter volume of the right superior parietal lobule,bilateral precuneus,but negatively correlated with grey matter of the left pons/ midbrain ; and the common score was negatively correlated with grey matter of the right inferior temporal gyrus,right inferior parietal lobule and left pons/midbrain.Conclusions These preliminary findings support that obvious multiple grey volume abnormality are in patients with early adulthood episode schizophrenia,and the gray matter volume of different brain regions are associated with symptoms severity.