目的探讨苯丙胺类药物所致精神病性障碍患者多个脑区白质纤维微结构的改变及其与精神病性症状的关系。方法应用弥散张量成像(diffusion tensor imaging,DTI)技术对40例苯丙胺类药物所致精神病性障碍男性患者和40例健康对照者的14个感兴趣区(region of interest,ROI)白质纤维微结构进行扫描,并采用独立样本t检验比较;应用简明精神病量表(brief psychiatric reacting scale,BPRS)评估其精神病性症状,并与DTI各指标进行相关分析。结果与对照组相比,苯丙胺类药物所致精神病性障碍组左侧前额叶白质各向异性分数(fraction alanisotropy,FA)降低[(0.42±0.12)vs.(0.46±0.08),P〈0.05];胼胝体膝部[(0.79±0.06)vs.(0.76±0.05),P〈O.01]、双侧顶叶[(0.76±0.09)vs.(0.71±0.04),P〈O.01;(0.74±0.08)vs.(0.71±0.05),P〈O.05j、右侧海马[(0.86±0.11)vs.(0.80±0.05),P〈O.01]表观扩散系数(apparent diffusion coefficient,ADC)值均升高。患者组左侧顶叶(r=0.44,P〈0.01;r=0.47,P〈O.01;r=0.37,P〈0.05)、右侧海马(r=0.36,P〈O.05;r=0.46,P〈0.01;r=0.39,P〈O.05)ADC值分别与BPRS总分、缺乏活力、思维障碍因子分呈正相关,左侧顶叶ADC值亦与敌对猜疑因子分正相关(r=0.33,P〈0.05)。结论苯丙胺类药物所致精神病性障碍患者前额叶白质、顶叶和海马存在白质微结构完整性和连接性异常,且顶叶和海马微结构改变与精神病性症状相关。
Objective To detect the microstructural changes of the brain white-matter in multiple regions of the inpatients with amphetamine type drugs-induced psychiatric disorders, and to explore the relationship between the brain whiter-matter microstructural changes and psychiatric symptoms. Methods Forty inpatients with amphetamine type drugs-induced psychiatric disorders and forty healthy comparison subjects were recruited to detect white-matter by diffusion tensor imaging (DTI) in 14 ROI and to assess clinical symptoms using The Brief Psychiatric Rating Scale (BPRS).The student's t-test and the Pearson correlation were employed for statistical analysis. Results Compared with healthy comparison subjects, the inpatients with amphetamine type drugs-induced psychiatric disorders group exhibited lower fraction alanisotropy (FA) value in left prefrontal white-matter [(0.42±0.12) vs. (0.46±0.08), P〈0.05], higher apparent diffusion coefficient (ADC) value in genu of corpus callosum[ (0.79±0.06) vs. (0.76±0.05), P〈0.01],bilateral parietal lobe [ (0.76±0.09)vs. (0.71±0.04), P〈0.01; (0.74±0.08) vs. (0.71±0.05), P〈0.05] and right hippocampus [ (0.86±0.11) vs.(0.80±0.05), P〈0.01) ]. ADC value of left parietal lobe white-matter (r=0.44,P〈0.01; r=0.47, P〈0.01; r= 0.37, P〈0.05) and right hippocampus (r=0.36, P〈0.05; r=0.46, P〈0.01; r=0.39, P〈0.05) was positive correlated with BPRS score, lack of vitality, disorders of thought factor scores within the patients group. Besides, left parietal lobe showed a positive correlation of ADC value with hostile suspicion factor score (r=0.33, P〈0.05). Conclusions The findings support the idea that the inpatients with amphetamine type drugs-induced psychiatric disorders produces white-matter microstruetural abnormalities of integrity and connectivity in prefrontal white-matter, parietal lobe, and hippoeampus. The parietal lobe and hippocampal mierostructural abnormalities are linked to psychia