Altered Interhemispheric and Temporal Lobe White Matter Microstructural Organization in Severe Chronic Schizophrenia
Altered Interhemispheric and Temporal Lobe White Matter Microstructural Organization in Severe Chronic Schizophrenia
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DOI：
10.1038/npp.2013.294
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发表时间：
2014-03-01
影响因子：
7.6
通讯作者：
Cannon, Dara M.
中科院分区：
文献类型：
--
作者：
Holleran, Laurena;Ahmed, Mohamed;Cannon, Dara M.
精神分裂症患者的弥散MRI检查提供了白质（WM）微结构组织异常的证据，主要表现在半球间、左额叶和颞叶WM的分数各向异性（FA）降低。使用基于束的空间统计（TBSS），我们检查了严重慢性精神分裂症患者样本中的扩散参数。采用西门子1.5T MRI扫描仪采集的64梯度方向序列（b = 1300 s/mm(2)），获取19例慢性重度精神分裂症患者和19例年龄和性别匹配的健康对照者的弥散MRI数据。精神分裂症的诊断采用精神障碍诊断与统计手册第四版（DSM- iv） DSM障碍（SCID）结构化临床访谈确定。患者有治疗耐药性，对至少两种抗精神病药物没有反应，并且有长时间的中度至重度阳性或阴性症状。采用TBSS对扩散参数进行了分析。慢性重度精神分裂症患者FA显著降低，胼胝体的膝、体、脾、右侧内囊后肢、右侧外囊和右侧颞下纵束的径向弥漫性相应增加。与对照组相比，患者中没有明显增加的FA体素。脾FA的减少与病程的延长有关。我们在以前没有接触过氯氮平的严重慢性精神分裂症患者的胼胝体和颞叶WM区域发现了广泛的异常扩散特性。这些缺陷可能由许多因素驱动，这些因素在体内扩散加权成像中无法区分，但可能与轴突数量或堆积密度减少、神经胶质细胞排列或功能异常以及髓磷脂减少有关。
Diffusion MRI investigations in schizophrenia provide evidence of abnormal white matter (WM) microstructural organization as indicated by reduced fractional anisotropy (FA) primarily in interhemispheric, left frontal and temporal WM. Using tract-based spatial statistics (TBSS), we examined diffusion parameters in a sample of patients with severe chronic schizophrenia. Diffusion MRI data were acquired on 19 patients with chronic severe schizophrenia and 19 age- and gender-matched healthy controls using a 64 gradient direction sequence, (b = 1300 s/mm(2)) collected on a Siemens 1.5T MRI scanner. Diagnosis of schizophrenia was determined by Diagnostic and Statistical Manual for Mental Disorders 4th Edition (DSM-IV) Structured Clinical Interview for DSM disorder (SCID). Patients were treatment resistance, having failed to respond to at least two antipsychotic medications, and had prolonged periods of moderate to severe positive or negative symptoms. Analysis of diffusion parameters was carried out using TBSS. Individuals with chronic severe schizophrenia had significantly reduced FA with corresponding increased radial diffusivity in the genu, body, and splenium of the corpus callosum, the right posterior limb of the internal capsule, right external capsule, and the right temporal inferior longitudinal fasciculus. There were no voxels of significantly increased FA in patients compared with controls. A decrease in splenium FA was shown to be related to a longer illness duration. We detected widespread abnormal diffusivity properties in the callosal and temporal lobe WM regions in individuals with severe chronic schizophrenia who have not previously been exposed to clozapine. These deficits can be driven by a number of factors that are indistinguishable using in vivo diffusion-weighted imaging, but may be related to reduced axonal number or packing density, abnormal glial cell arrangement or function, and reduced myelin.