Diffusion tractography of the fornix in schizophrenia.
Diffusion tractography of the fornix in schizophrenia.
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DOI：
10.1016/j.schres.2008.10.022
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发表时间：
2009-01
影响因子：
4.5
通讯作者：
Shenton, M. E.
中科院分区：
文献类型：
--
作者：
Fitzsimmons, J.;Kubicki, M.;Smith, K.;Bushell, G.;Estepar, R. San Jose;Westin, C. -F.;Nestor, P. G.;Niznikiewicz, M. A.;Kikinis, R.;McCarley, R. W.;Shenton, M. E.
白色物质纤维束，特别是那些连接额叶和颞叶的纤维束，可能与精神分裂症的病理生理学有关。然而，很少有研究集中在穹窿，一个紧凑的束白色物质纤维，从海马突出到隔膜，丘脑和乳头体的前核。扩散张量成像（DTI）和一种新的后处理方法，纤维束成像，提供了一个独特的机会，可视化和量化整个轨迹的纤维束，如穹窿，在体内。我们应用这些技术来量化穹窿扩散各向异性精神分裂症。采用DTI图像对36例男性慢性精神分裂症患者和35例男性健康人的左右穹窿进行评估，年龄、父母社会经济地位和利手性分组匹配。手动绘制感兴趣区域，对组成员不知情，以指导纤维束成像，并计算每个受试者整个纤维束的各向异性分数（FA）（纤维完整性的测量）并取平均值。门和人测试（DPT）用于评估视觉和言语记忆，联合回忆和联合识别。进行方差分析，结果表明，精神分裂症患者和对照组之间的差异穹窿FA（P=0.006）。保护性事后独立样本t检验显示，与对照组受试者相比，精神分裂症患者双侧FA降低（左侧：P=0.048;右侧P=0.006）。对照组中，穹窿FA较高与DPT和综合视觉记忆（r=.554，p=.026）、综合言语记忆（r=.647，p=.007）、综合回忆（r=.516，p=.041）和综合识别（r=.710，p=.002）的测量值在统计学上显著相关。在患者组中没有发现这种统计学显著相关性。我们的研究结果显示了应用DTI和纤维束成像研究精神分裂症患者体内白色纤维束的实用性。具体来说，我们观察到了精神分裂症患者穹窿完整性的双侧破坏，从而拓宽了我们对这种疾病的病理生理学的理解。
White matter fiber tracts, especially those interconnecting the frontal and temporal lobes, are likely implicated in pathophysiology of schizophrenia. Very few studies, however, have focused on the fornix, a compact bundle of white matter fibers, projecting from the hippocampus to the septum, anterior nucleus of the thalamus and the mamillary bodies. Diffusion Tensor Imaging (DTI), and a new post-processing method, fiber tractography, provides a unique opportunity to visualize and to quantify entire trajectories of fiber bundles, such as the fornix, in vivo. We applied these techniques to quantify fornix diffusion anisotropy in schizophrenia. DTI images were used to evaluate the left and the right fornix in 36 male patients diagnosed with chronic schizophrenia and 35 male healthy individuals, group matched on age, parental socioeconomic status, and handedness. Regions of interest were drawn manually, blind to group membership, to guide tractography, and Fractional Anisotropy (FA), a measure of fiber integrity, was calculated and averaged over the entire tract for each subject. The Doors and People test (DPT) was used to evaluate visual and verbal memory, combined recall and combined recognition. Analysis of variance was performed and findings demonstrated a difference between patients with schizophrenia and controls for fornix FA (P=0.006). Protected post-hoc independent sample t-tests demonstrated a bilateral FA decrease in schizophrenia, compared with control subjects (left side: P=0.048; right side P=0.006). Higher fornix FA was statistically significantly correlated with DPT and measures of combined visual memory (r=.554, p=.026), combined verbal memory (r=.647, p=.007), combined recall (r=.516, p=.041), and combined recognition (r=.710, p=.002) for the control group. No such statistically significant correlations were found in the patient group. Our findings show the utility of applying DTI and tractography to study white matter fiber tracts in vivo in schizophrenia. Specifically, we observed a bilateral disruption in fornix integrity in schizophrenia, thus broadening our understanding of the pathophysiology of this disease.
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