中国科学院心理健康重点实验室知识库

摘要:精神分裂症患者在大脑结构上存在异常，已有研究表明灰质体积的异常广泛存在于分裂症患者大脑如额叶，颞叶及顶叶等脑区，但目前仍然不清楚长期住院对精神分裂症患者脑结构的改变是否存在影响。

本研究共招募21名健康被试和46名精神分裂症患者，其中21名为长期住院15年以上的患者，25名为社区康复的患者（15年内住院时间不超过6个月），所有被试完成T1加权脑结构像磁共振扫描。采用基于体素的形态学分析方法(voxel-based morphometry)进行脑成像数据的预处理，并使用方差分析考察灰质体积的组间差异（FDR校正，p<0.05）。使用MarsBar将差异脑区定义为感兴趣区并提取其灰质体积，进一步用SPSS软件分析患者组之间的差异及其与健康对照组之间的差异。方差分析结果发现，三组被试之间存在显著差异的脑区主要包括丘脑、左侧眶额叶、右侧梭状回、左侧颞上回、右侧角回、右侧舌回、右侧扣带后回及左侧海马旁回；事后检验发现，与健康对照组相比，住院患者与社区康复患者在以上区域的灰质体积显著减少，同时住院精神分裂症患者在丘脑及右侧舌回的灰质体积显著小于社区康复患者。

综上所述，大脑灰质体积的异常在长期住院与社区康复的精神分裂症患者身上均出现，而这样的异常在长期住院患者的部分特定脑区中相对更为明显，因此，脑结构的异常是精神分裂症患者的一种病理学特质，而长期住院可能对精神分裂症患者大脑结构异常有一定影响。

Abstract:Altered brain volumes have been observed in patients with schizophrenia patients in frontal lobe, temporal lobe and parietal lobe. However, it is still not clear the exact long-lasting impact of long-term institutionalization on grey matter volume in patients with schizophrenia. This study recruited 21 institutionalizedpatients with schizophrenia, and 25 community-dwelling patients with schizophrenia and 21 healthy controls. All of them underwent a T1 Weighted Image magnetic resonance imaging. Voxel-based morphometry analysis was run with variance analysis (ANOVAS) on grey matter volume (FDR adjusted，p-values <0.05). The results showedsignificant differences among the three groups were in thalamus, left orbital gyrus, right fusiform gyrus, left sup temporal gyr, right anguar gyrus, right lingual, right pos cingulate, and left parahippoampus. Subsequent post-hoc analyses further indicated that these differences were mainly found between institutionalized schizophrenia and healthy controls, community-dwelling patients and healthy controls; the reduction in thalamus and right lingual gyrus were most severe in institutionalized patients. These findings support the impact of institutionalization up on gray matter volume in patients with schizophrenia.