Assessment of cerebral blood volume in schizophrenia:: A magnetic resonance imaging study
Assessment of cerebral blood volume in schizophrenia:: A magnetic resonance imaging study
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DOI：
10.1016/j.jpsychires.2006.03.002
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发表时间：
2007-09-01
影响因子：
4.8
通讯作者：
Tansella, Michele
中科院分区：
文献类型：
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作者：
Brambilla, Paolo;Cerini, Roberto;Tansella, Michele
精神分裂症患者一直存在脑萎缩现象，这是解剖学异常的“粗略”证据。先前的小型SPECT研究表明，精神分裂症患者的脑血容量(CBV)减少可能伴随着脑体积的缩小。在这项研究中，我们使用灌注加权成像(PWI)对大样本精神分裂症患者的大脑半球脑血流量进行了无创性研究。54例DSM-IV精神分裂症患者(平均年龄+/-SD=39.19±12.20岁；男34例，女20例)和24例正常对照(平均年龄SD=44.63±10.43岁；男9例，女15例)在静脉注射顺磁性造影剂(Gd-DTPA)后，用1.5T西门子磁体(TR=2160ms，TE=47ms，层厚=5 mm)进行PWI成像。在两幅轴位图像上，以对比剂(Sm)通过过程中最大信号强度下降与基线给药前信号强度(So)之比(CE=Sm/So×100)逐个像素计算增强对比度(CE)。与正常对照组相比，精神分裂症患者双侧大脑半球CE值显著升高(p=0.02)，而反向CE偏侧指数显著升高(p=0.02)。这项研究显示，在大量精神分裂症患者中，大脑半球CBV异常减少和倒置。假设慢性低CBV可能导致神经失活和伴随的自由基增加，最终导致神经元丢失和认知损害。因此，颅内血流动力学改变可能伴随脑萎缩和认知障碍，这是精神分裂症病理生理学中的一个关键因素。(C)2006爱思唯尔有限公司。保留所有权利。
Brain atrophy has consistently been observed in schizophrenia, representing a 'gross' evidence of anatomical abnormalities. Reduced cerebral blood volume (CBV) may accompany brain size decrement in schizophrenia, as suggested by prior small SPECT studies. In this study, we non-invasively investigated the hemisphere CBV in a large sample of patients suffering from schizophrenia with perfusion-weighted imaging (PWI). PWI images were obtained, following intravenous injection of paramagnetic contrast agent (Gadolinium-DTPA), for 54 DSM-IV patients with schizophrenia (mean age +/- SD = 39.19 +/- 12.20 years; 34 males, 20 females) and 24 normal controls (mean age SD = 44.63 +/- 10.43 years; 9 males, 15 females) with a 1.5T Siemens magnet using an echo-planar sequence (TR = 2160 ms, TE = 47 ms, slice thickness = 5 mm). The contrast of enhancement (CE), a semi-quantitative parameter inversely estimating the CBV, were calculated pixel by pixel as the ratio of the maximum signal intensity drop during the passage of contrast agent (Sm) by the baseline pre-bolus signal intensity (So) (CE = Sm/So x 100) for right and left hemisphere on two axial images. Specifically, higher CE values correspond to lower CBV and viceversa Compared to normal controls, patients with schizophrenia had significantly higher bilateral hemisphere CE values (p = 0.02) and inverse CE laterality index (p = 0.02). This study showed abnormally reduced and inverse hemisphere CBV in a large population of patients with schizophrenia. Hypothetically, chronic low CBV may sustain neural hypoactivation and concomitant increase of free radicals, ultimately resulting in neuronal loss and cognitive impairments. Thus, altered intracranial hemodynamics may accompany brain atrophy and cognitive deficits, being a crucial factor in the pathophysiology, of schizophrenia. (c) 2006 Elsevier Ltd. All rights reserved.