基于象素形态测量法分析精神分裂症患者脑白质结构*☆
董问天1,刘 琳1,2,裴新龙3,袁慧书3,谢敬霞3,阎 浩1,张 岱1
Voxel-based morphometric analysis on the structure of white matter in schizophrenic patients *☆
Abstract
AIM: To assess the difference in the structure of brain white matter between schizophrenic patients and healthy controls by using voxel-based morphometry (VBM).
METHODS:①Grouping: Ten schizophrenic patients (according to ICD-10 and DSM-Ⅳ) were enrolled from the Institute of Mental Health, Peking University and Beijing Huilongguan Hospital between April 2005 and March 2006. Moreover, ten healthy volunteers who matched well in age, gender and educational level were taken as controls, and all the subjects were signed the informed consents.②Detection method and parameters: All the subjects were scanned by Siemens Sonata 1.5T MRI system. A series of 96 contiguous sagittal images were acquired using a magnetization prepared rapid gradient echo(MPRAGE) sequence with the following parameters: TR=1 900 ms; TE=3.93 ms; 15° flip angle; field of view (FOV)= 220 mm×220 mm; voxel dimensions were 0.43 mm×0.43 mm×1.70 mm.③Data process: The data were processed by the VBM5 toolbox on the latest version of SPM5. All primary images were registered to the ICBM152 template (Montreal Neurological Institute). The spatially normalized images were resliced with a final voxel size of 2 mm×2 mm×2 mm; The VBM5 toolbox extended the core segmentation algorithm by the Hidden Markov Random Field(HMRF). The images of no modulation were adopted to measure the density of white matter; The segmented images were smoothed using a 12-mm Full Width at Half Maximization (FWHM) isotropic Gaussian kernel. Statistical analyses were carried out on specify 2nd-level of SPM5. The resulting set of voxel values for this contrast constituted a Statistical Parametric Map of the t test. The threshold at P < 0.001(not corrected, t > 3.61) and threshold extended 20 voxels, were taken as different encephalic region.
RESULT: All 20 subjects were involved in the result analysis. Compared to healthy controls, the schizophrenic patients significantly decreased the density of white matter, which was found in the bilateral inferior temporal gyrus, bilateral inferior frontal gyrus, bilateral fusiform gyrus, left parahippocampus, left corpus callosum, left thalamus, left inferior parietal lobule, left precuneus, right middle frontal gyrus, and right middle temporal gyrus.
CONCLUSION:①The deficit of white matter is widespread in brain regions of schizophrenic patients. Combined with result of functional MRI on same patients and healthy controls in another study, it is suggested that left thalamus and bilateral fusiform gyrus have a close relationship with schizophrenia.②VBM is the fast and automatic approach and has the advantage of not being affected by researchers.
Dong WT, Liu L, Pei XL, Yuan HS, Xie JX, Yan H, Zhang D.Voxel-based morphometric analysis on the structure of white matter in schizophrenic patients.Zhongguo Zuzhi Gongcheng Yanjiu yu Linchuang Kangfu 2007;11(13):2454-2458(China)
[www.zglckf.com/zglckf/ejournal/upfiles/07-13/13k-2454(ps).pdf]
1Institute of Mental Health, Peking University, Beijing 100083, China; 2Beijing Huilongguan Hospital, Beijing 102208, China; 3Department of Radiology, Peking University Third Hospital, Beijing 100083, China
Dong Wen-tian☆, Doctor, Attending physician, Institute of Mental Health, Peking University, Beijing 100083, China
dongwentian@bjmu.edu.cn
Correspondence to: Zhang Dai, Doctor, Professor, Institute of Mental Health, Peking University, Beijing 100083, China
daizhang@bjmu.edu.cn
Supported by: the National Natural Science Foundation of China, No. 305302290*
Received: 2007-02-13
Accepted: 2007-03-15
摘要
目的:应用基于象素的形态测量学方法,分析精神分裂症大脑白质结构与健康人的差异。
方法:①分组:精神分裂症组为10名北京大学精神卫生研究所和北京回龙观医院2005-04/2006-03收治,符合ICD-10、DSM-Ⅳ精神分裂症偏执型诊断标准的患者;健康对照组是年龄、性别和受教育程度与精神分裂症组相匹配的健康志愿者10名。所有受试者均签署知情同意书。②检测方法和参数:采用西门子1.5T Sonata MRI成像系统,对所有受试者行全脑扫描,解剖图像采用T1加权序列矢状成像(MPRAGE),共采集96层。TR=1 900 ms,TE=3.93 ms,flip 15°,FOV= 220 mm×220 mm,图像分辨率0.43 mm×0.43 mm×1.70 mm。③数据处理:在SPM5平台上,使用VBM5工具箱进行技术进行处理。采用MNI的标准脑图谱配准,配准后图像分辨率2 mm×2 mm×2 mm;采用HMRF算法进行组织分割,目标是测量白质密度,故未经体积调制;用12 mm半高全宽高斯核对脑白质密度图进行平滑;然后采用SPM的组分析方法,对两组进行成组t检验,t >3.61,P < 0.001(未校正)、相连象素大于20个的信号变化脑区视为有差异脑区。
结果:20名受试者均完成测试进入结果分析。精神分裂症组密度低于对照组的区域有双侧颞下回、双侧额下回、双侧梭状回、左侧海马旁回、左侧胼胝体、左侧丘脑、左侧顶下叶、左侧楔前叶、右侧额中回、右侧颞中回,没有发现精神分裂症组白质密度高于对照组的区域。
结论:①精神分裂症患者白质缺陷部位广泛。结合同一研究对象的功能磁共振成像研究结果提示左侧丘脑和双侧梭状回与精神分裂症有密切关系。②基于象素的形态测量学的方法有快速和全自动的特点,具有不受分析人员主观影响等优点。
关键词:磁共振成像?鸦基于体素的形态学分析?鸦 精神分裂症?鸦 白质?鸦 丘脑?鸦 梭状回;康复工程
董问天,刘琳,裴新龙,袁慧书,谢敬霞,阎浩,张岱.基于象素形态测量法分析精神分裂症患者脑白质结构[J].中国组织工程研究与临床康复,2007,11(13):2454-2458 [www.zglckf.com/zglckf/ejournal/upfiles/07-13/13k-2454(ps).pdf]
1北京大学精神卫生研究所,北京市 100083;2北京回龙观医院,北京市 102208;3北京大学第三医院放射科,北京市 100083
董问天☆,男,1971年生,山西省阳泉市人,汉族,1997年北京医科大学毕业,博士,主治医师,主要从事精神障碍影像学研究。
dongwentian@bjmu.edu.cn
通讯作者:张 岱,博士,教授,北京大学精神卫生研究所,北京市 100083
daizhang@bjmu.edu.cn
国家自然科学基金资助项目(305302290)*
中图分类号:R319 文献标识码:A
文章编号:1673-8225
(2007)13-02454-05
收稿日期:2007-02-13
修回日期:2007-03-15
(07-50-2-984/N·Y)
课题背景:课题为国家自然科学基金资助项目(305302290)。课题利用多学科交叉优势,采用磁共振技术检测精神分裂症患者认知功能损害的关联脑区;利用大样本遗传资源的优势,筛选与精神分裂症关联的神经发育相关易感基因。继而构建细胞和生物模型,用分子生物学和细胞生物学方法对筛选出的易感基因进行功能分析。预期结果有助于发现精神分裂症认知功能损害的生物学基础,为病因学诊断和发展新的治疗方法提供线索资料。
相关链接:基于象素的形态测量学方法自从问世以来,由于其方便性和可重复性,在精神障碍的相关研究中得到广泛应用,为通过磁共振成像研究灰质、白质结构提供了新的方法。目前,精神分裂症神经发育和神经退行性变两种假说并存,都有各自的证据,精神分裂症患者白质的功能和形态的研究越来越得到重视,下一步将重点研究精神分裂症患者脑结构的随访观察。
同行评价:用脑影像学方法研究精神分裂症病因学,国内外的结果不一致。以往在结构影像学上,脑灰质的研究是重点,近年来则侧重于脑白质的研究,因此文章的选题新颖,设计合理,对探讨精神分裂症的病因有一定的价值。如今后继续研究希望能增加样本量,按症状类型和病程特点进行分层分析,进一步改进分析方法,获得更有说服力的结果。
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