Abnormal white matter microstructure in drug-naive first episode schizophrenia patients before and after eight weeks of antipsychotic treatment
Abnormal white matter microstructure in drug-naive first episode schizophrenia patients before and after eight weeks of antipsychotic treatment
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DOI：
10.1016/j.schres.2016.01.051
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发表时间：
2016-04
影响因子：
4.5
通讯作者：
Botao Zeng;B. Ardekani;Yingying Tang;T. Zhang;Shan-Yao Zhao;Huiru Cui;Xiaoduo Fan;K. Zhuo;
中科院分区：
文献类型：
--
作者：
Botao Zeng;B. Ardekani;Yingying Tang;T. Zhang;Shan-Yao Zhao;Huiru Cui;Xiaoduo Fan;K. Zhuo;
背景在首发精神分裂症患者中有异常白色物质完整性的报道。然而，它是否可以被扭转短期抗精神病药物的研究结果是不一致的。MethodDiffusion tensor imaging（DTI）从55药物初治的首发精神分裂症患者和61名健康对照组，并重复25例患者和31名对照8周后，在此期间，患者服用抗精神病药物。白色物质的完整性使用分数各向异性（FA）、平均扩散率（MD）、轴向扩散率（AD）和径向扩散率（RD）来测量。这些措施显示了组间差异的轨道为基础的空间统计（TBSS）在基线提取纵向comparation.ResultsAt基线，患者表现出较低的FA，较高的MD和较高的RD与对照组钳，左上级纵向束，额枕下束，左皮质脊髓束，左钩束，左丘脑前辐射，和双边下纵向束。精神分裂症患者的FA值与阴性症状（r =-0.412，P = 0.002）、工作记忆（r = 0.377，P = 0.005）和视觉学习（r = 0.281，P = 0.038）相关。DTI指数的纵向变化，在这些管道没有不同的患者和对照组之间。但患者左侧上级纵束FA值的纵向变化与阳性症状的变化相关（r =-0.560，p = 0.004），以及加工速度的变化（r = 0.469，p = 0.018）结论脑白质缺损在本研究中得到了相对较大样本的药物初治和首发精神分裂症患者的验证，可能与阴性症状和认知障碍相关，而左侧上级纵束白色物质完整性的改善与精神病和处理速度的改善相关。进一步检查治疗相关的白色物质完整性变化可能为抗精神病药物反应机制提供线索，并为临床研究提供生物标志物。
BackgroundAbnormal white matter integrity has been reported among first episode schizophrenia patients. However, findings on whether it can be reversed by short-term antipsychotic medications are inconsistent.MethodDiffusion tensor imaging (DTI) was obtained from 55 drug-naive first episode schizophrenia patients and 61 healthy controls, and was repeated among 25 patients and 31 controls after 8 weeks during which patients were medicated with antipsychotics. White matter integrity is measured using fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD). These measures showing a group difference by Tract-based spatial statistics (TBSS) at baseline were extracted for longitudinal comparisons.ResultsAt baseline, patients exhibited lower FA, higher MD and higher RD versus controls in forceps, left superior longitudinal fasciculus, inferior fronto-occipital fasciculus, left corticospinal tract, left uncinate fasciculus, left anterior thalamic radiation, and bilateral inferior longitudinal fasciculi. FA values of schizophrenia patients correlated with their negative symptoms (r = − 0.412, P = 0.002), working memory (r = 0.377, P = 0.005) and visual learning (r = 0.281, P = 0.038). The longitudinal changes in DTI indices in these tracts did not differ between patients and controls. However, among the patients the longitudinal changes in FA values in left superior longitudinal fasciculus correlated with the change of positive symptoms (r = − 0.560, p = 0.004), and the change of processing speed (r = 0.469, p = 0.018).ConclusionsWhite matter deficits were validated in the present study by a relatively large sample of medication naïve and first episode schizophrenia patients.They could be associated with negative symptoms and cognitive impairment, whereas improvement in white matter integrity of left superior longitudinal fasciculus correlated with improvement in psychosis and processing speed. Further examination of treatment-related changes in white matter integrity may provide clues to the mechanism of antipsychotic response and provide a biomarker for clinical studies.