目的比较有无冲动攻击行为精神分裂症脑灰质结构的不同。方法收集16例有冲动攻击行为和24例无冲动攻击行为的首发未用药的精神分裂症患者,以三维快速扰相梯度回波序列获得其脑部磁共振成像。所得图像以统计参数图软件包进行预处理,然后两组脑局部灰质体积进行t检验。结果有冲动攻击行为组右侧中央前回、中央后回区(MNI:x=44,y=-4,z=58;体素集合数:851)和右侧眶额回区(MNI:x=20.y=34.z=-24,体素集合数=108)脑灰质体积小于无冲动攻击行为组,差异有统计学意义(t=-3.72,P〈0.001:t=3.17,P〈0.001)。未发现冲动攻击行为组存在灰质体积大于无冲动攻击行为组的脑区。结论右侧中央前回、中央后回和眶额回灰质异常与精神分裂症的冲动攻击行为可能有关。
Objective To compare the regional gray matter volumetric changes between schizophrenic patients with and without impulsive offensive behavior. Methods Sixteen first-episode-schizophrenia patients with impulsive offensive behavior and 24 first-episode-schizophrenia patients without impulsive offensive behavior underwent T1 weighted magnetic resonance imaging. Scans were normalized, uniformed segmented, modulated and smoothed using the statistical parametric mapping 5 (SPMS), and the regional gray matter volumes were compared by two-sample t-test with VBM-box in SPM5 software. Results The patients with impulsive offensive behavior demonstrated significant decrease of the gray matter volumes in the right precentral gyrus and postcentral gyrus (MNI : x = 44,y = -4, z = 58 ; cluser = 851 voxels, t = -3.72, P 〈 0.001 ) as well as the right or bitofrontal gyrus (MNI:x = 20, y = 34, z = -24; cluster = 108 voxels, t = - 3.17, P〈 0.001 ). Conclusion The altered regional gray matter in the right precentral gyms, postcentral gyrus and right or bitofrontal gyrus may be involved in the neural mechanism of impulsive offensive behavior in schizophrenia.