摘要
目的探讨首发精神分裂症患者脑代谢物非对称性的改变及其受非典型抗精神病药物治疗的影响。方法对符合美国精神障碍诊断与统计手册第4版(Diagnostic and Statistical Manual of Mental Disorders,DSM-Ⅳ)诊断标准的21例首发精神分裂症患者和21名健康对照进行氢质子磁共振波谱扫描,并在治疗1年后对患者再次进行扫描,检测双侧额叶白质和海马的N-乙酰天门冬氨酸(N-Acetylaspartate,NAA)、胆碱(choline,Cho)和肌酸(creatine,Cr),以Cr为参照物,分别计算双侧NAA/Cr、Cho/Cr比值。在治疗前后对患者进行阳性和阴性量表(positive and negcotive symtoms scale,PANSS)、大体功能量表(global assessment function,GAF)评定。采用配对t检验进行脑代谢物非对称性分析。结果非对称性分析发现基线期健康对照组左侧海马NAA/Cr比右侧高[(1.41±0.09)vs.(1.32±0.10),P<0.05],首发精神分裂症组左、右侧海马代谢物比较,差异无统计学意义;而经过1年治疗后,与治疗前相比首发精神分裂症组PANSS评分显著降低(68.57±27.74vs.97.95±13.81)、GAF量表评分显著增加(58.76±23.07 vs.28.05±8.99),均P<0.05,精神分裂症组左侧海马NAA/Cr比右侧高[(1.41±0.10)vs.(1.31±0.13),P<0.05]。健康对照组及首发精神分裂症组治疗前后双侧额叶白质代谢物差异均无统计学意义(P>0.05)。结论首发精神分裂症患者海马NAA/Cr的非对称性消失,经非典型抗精神病药物治疗后,在精神症状改善的同时海马NAA/Cr的非对称性恢复。
Objective To investigate asymmetric changes of the prefrontal lobes and hippocampus before and after treatment in first-episode schizophrenia patients using proton magnetic resonance spectroscopy（1H-MRS）.Method 21 first-episode schizophrenia patients and 21 healthy subjects matched for age,gender,and years of education were included in the study.1H-MRS was performed in two sides of the hippocampus and frontal lobes regions before and one year after treatment The ratios of N-Acetylaspartate（NAA）,choline（Cho） to creatine（Cr） were measured.The patients were also assessed by（positive and negative symptoms scale,PANSS） and（global assessment fumction,GAF）.One-sample T test and paired-samples T test were used for statistic process.Results The NAA / Cr was significantly higher in the left hippocampus than in the right（1.41 ± 0.09 vs.1.32 ± 0.10） for healthy control subjects（P 0.05）.There are no significant difference in brain metabolites between the left and right hippocampus in the first episode schizophrenia patients（P 0.05）.One year following treatment,the NAA / Cr ratio was significantly higher in the left hippocampus than in the right（1.41 ± 0.09 vs.1.32 ± 0.10） for the schizophrenia patents concomitant with the improvements of PANSS（58.76 ± 23.07 vs 28.05 ± 8.99） and GAR（68.52 ± 27.74 vs.97.95 ± 13.81）（P 0.05）.There was no significant difference at brain metabolites between the left and right frontal lobes regions in the first episode schizophrenia patients before and after treatment and healthy control subjects.Conclusion Asymmetry of NAA / Cr disappears in the hippocampus in the first-episode schizophrenia whereas treatment of atypical antipsychotics can attenuate the asymmetry of NAA / Cr.
出处
《中国神经精神疾病杂志》
CAS
CSCD
北大核心
2012年第5期257-261,共5页
Chinese Journal of Nervous and Mental Diseases
基金
国家自然科学基金重点项目(编号:30530300)
973课题(编号:2007CB12301)
关键词
精神分裂症
额叶
海马
磁共振波谱
Schizophrenia Frontal lobe Hippocampus Magnetic resonance spectroscopy
