A diffusion tensor imaging study of structural dysconnectivity in never-medicated, first-episode schizophrenia
A diffusion tensor imaging study of structural dysconnectivity in never-medicated, first-episode schizophrenia
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DOI：
10.1017/s0033291707001808
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发表时间：
2008-06-01
影响因子：
6.9
通讯作者：
Chua, S. E.
中科院分区：
文献类型：
--
作者：
Cheung, V.;Cheung, C.;Chua, S. E.
背景。弥散张量成像（DTI）可用于研究未服药的首发精神分裂症患者的大脑结构连通性。招募了根据DSM-IV-R从未接触过抗精神病药物的首发精神分裂症患者（n=25）和健康对照（n=26）。各组按年龄、性别、父母的最佳社会经济地位和种族进行匹配。所有受试者均接受DTI和结构磁共振成像（MRI）扫描。采用基于体素的分析来研究各组间分数各向异性（FA）值差异显著的脑区。对FA分数进行了验证性兴趣区域（ROI）分析，其中区域对组成员性视而不见。患者FA值显著低于健康对照组的部位为左侧额枕束、左侧下纵束、右侧楔前叶附近白质、胼胝体脾、右侧内囊后肢、右侧黑质附近白质、左侧脑蒂。胼胝体的ROI分析证实，患者组脾脏的平均FA值明显低于对照组，而胚芽中的FA值则不低于对照组。独立ROI测量的类内相关系数（ICC）为0.90（膝）和0.90（脾）。患者的FA值没有明显高于健康对照组的区域。广泛的结构连通性障碍，包括皮质下区域，已经出现在神经阻滞剂首次发病的患者中。
Background. Diffusion tensor imaging (DTI) can be used to investigate cerebral structural connectivity in never-medicated individuals with first-episode schizophrenia.Method. Subjects with first-episode schizophrenia according to DSM-IV-R who had never been exposed to antipsychotic medication (n=25) and healthy controls (n=26) were recruited. Groups were matched for age, gender, best parental socio-econornic status and ethnicity. All subjects underwent DTI and structural magnetic resonance imaging (MRI) scans. Voxel-based analysis was performed to investigate brain regions where fractional anisotropy (FA) values differed significantly between groups. A confirmatory region-of-interest (ROI) analysis of FA scores was performed in which regions were placed blind to group membership.Results. In patients, FA values significantly lower than those in healthy controls were located in the left fronto-occipital fasciculus, left inferior longitudinal fasciculus, white matter adjacent to right precuneus, splenium of corpus callosum, right posterior limb of internal capsule, white matter adjacent to right substantia nigra, and left cerebral peduncle. ROI analysis of the corpus callosum confirmed that the patient group had significantly lower mean FA values than the controls in the splenium but not in the germ. The intra-class correlation coefficient (ICC) for independent ROI measurements was 0.90 (genu) and 0.90 (splenium). There were no regions where FA values were significantly higher in the patients than in the healthy controls.Conclusions. Widespread structural dysconnectivity, including the subcortical region, is already present in neuroleptic-naive patients in their first episode of illness.