上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

精神分裂症患者急性期药物治疗前后的脑灰质变化

项琼 1，王颖婵 1*，朱殿明 1，卓恺明 1，王征 2，徐一峰 1，刘登堂 1   

  1. 1. 上海交通大学 医学院附属精神卫生中心精神病性障碍科，上海 200030；2. 中国科学院神经科学研究所，上海 200031
  • 出版日期:2017-02-28 发布日期:2017-02-28
  • 通讯作者: 刘登堂，电子信箱：erliu110@126.com。
  • 作者简介:项琼（1981—），女，硕士生；电子信箱：xiangqiongxl@126.com。王颖婵（1981—），女，硕士生；电子信箱： 138182341@163.com。*为共同第一作者。
  • 基金资助:

    国家自然科学基金（81371479）；上海市科学技术委员会引导类项目(15411964400)；上海市卫生和计划生育委员会项目（2014ZYJB0002，20134006，20144Y0054)；上海市市级医院适宜技术项目(SHDC12014214)；上海市精神疾病临床医学中心项目（2014）；上海市精神卫生中心早期精神病性障碍科项目（2013-YJTSZK-05）；上海市自然科学基金（16ZR1430500）

Changes of cerebral gray matter pre- and post-treatment in patients with schizophrenia

XIANG Qiong1, WANG Ying-chan1*, ZHU Dian-ming1, ZHUO Kai-ming1, WANG Zheng2, XU Yi-feng1, LIU Deng-tang1   

  1. 1. Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; 2. Institute of Neuroscience, Shanghai Institute for Biological Science, Chinese Academy of Science, Shanghai 200031, China
  • Online:2017-02-28 Published:2017-02-28
  • Supported by:

    National Natural Science Foundation of China, 81371479; Foundation of Science and Technology Commission of Shanghai Municipality, 15411964400; Foundation of Shanghai Municipal Health and Family Planning Commission, 2014ZYJB0002, 20134006, 20144Y0054; Shanghai Municipal Hospital Appropriate Technology Programme, SHDC12014214; Project of Shanghai Clinical Center for Mental Disorders, 2014; Early Psychosis Program of Shanghai Mental Health Center, 2013-YJTSZK-05; Natural Science Foundation of Shanghai, 16ZR1430500

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摘要：

目的 ·探讨短期药物治疗对精神分裂症急性期患者大脑结构（尤其是灰质）的影响。方法 ·共 27例未服药的早期精神分裂症患者（病程不超过5年）和21名健康志愿者入组，其中27例患者接受抗精神病药物治疗8周，分别于基线及8周后（21例）精神分裂症患者及21例健康志愿者）进行3T磁共振扫描。使用基于体素的形态学分析（VBM）方法分析大脑灰质体积及其变化。结果 ·与健康对照组比较，精神分裂症患者的左侧小脑后叶、左侧颞中回及双侧海马旁回的灰质容积减少（P=0.000，体素>50)。8周后随访，健康对照组的灰质体积无变化。经抗精神病药物治疗8周后，精神分裂症患者较多脑区的灰质容积缩小，主要包括双侧颞上回、颞中回、颞下回，双侧额上回、额中回、额下回，双侧海马旁回及扣带回，右侧缘上回，右侧小脑后叶，右侧舌状回(P=0.000，体素>50)。结论 ·抗精神病药物短期治疗（8周）对急性期精神分裂症患者的大脑灰质可能产生不利影响，引起灰质体积的缩小。

关键词: 精神分裂症, 灰质, 基于体素的形态学分析, 抗精神病药物, 磁共振成像

Abstract:

Objective · To observe the changes of cerebral gray matter pre- and post-treatment with short term drugs in patients with schizophrenia. Methods · T1-weighted brain MRIs were obtained on a 3T scanner in 21 controls and 27 subjects with schizophrenia who were not given antipsychotic medication. The controls and 21 schizophrenia patients received the second scan after 8 weeks of antipsychotic treatment. Voxel-based morphometry (VBM) were used to investigate the differences in gray matter (GM), mainly about the regional GM volumes. Results · GM volumes were significantly smaller in the patient group than those of healthy controls in left cerebellum posterior lobe , left and right parahippocampalgyrus, left middle temporal gyrus(P=0.000, voxels>50). GM volumes extensively decreased after 8 weeks of antipsychotic-treatment compared with pre-treatment in the superior, middle, and inferior temporal gyri, superior,middle and inferior frontal gyri, parahippocampa gyri, cingulate gyri, right supramarginal gyrus, right cerebellum posterior lobe, and right lingual gyrus(P=0.000, voxels>50). Conclusion · Short term antipsychotic treatment (8 weeks) may have adverse effects on the gray matter of patients with acute schizophrenia by reducing the volume of gray matter.

Key words: schizophrenia, grey matter, voxel-based morphometry, antipsychotics, magnetic resonance imaging