目的：探讨首发精神分裂症患者和复发精神分裂症患者脑灰质异常区域的差异。方法：对28例首发和27例复发精神分裂症患者和40例在年龄、性别、教育等方面与之相匹配的正常对照采用优化的基于体素的形态测量学（VBM）方法对大脑灰质体积进行测量,经协方差分析得出3组之间总体差异后,将总体差异区域中的各个团块作为感兴趣区（ROI）,利用Easy Volumes测量所有被试各ROI的灰质体积,进一步比较3组之间差异。结果：与正常人相比,精神分裂症病人在内侧前额叶、前扣带回、左侧额中回及右侧罗兰氏岛盖、缘上回等区域存在灰质体积下降。而复发病人相较首发病人仅在右侧罗兰氏岛盖部和缘上回区域存在灰质体积下降。结论：精神分裂症患者在首次发作后仍会有脑结构的进行性改变,在疾病不同阶段可有不同脑区受损,且默认网络脑结构的改变可能是精神分裂症的病理生理机制之一。
Objective： To investigate the differences of gray matter volumes between first-episode （FES） and recurrently ill （REZ） patients with schizophrenia. Methods： We examined structural brain changes in 28 first-episode and 27 recurrently ill patients with schizophrenia and 40 matched healthy control subjects by using optimized voxel-based morphometry method. The whole struc- tural differences between three groups were evaluated by using analysis of covariance （ANCO- VA） model. The results were corrected by family-wise-error （FWE） method and then were used as ROIs. Then the Easy Volumes was used to measure the gray matter volumes of the ROIs. Results： Compared to healthy control subjects, there were significant grey matter volumes reduc- tions in schizophrenia patients, including anterior cingulate, bilateral medial prefrontal cortex, right rolandic operculum, right supramarginal gyrus and left middle frontal gyrus. This pattern also existed in REZ patients, furthermore, REZ patients showed extended alterations within right rolandic operculum and right supramarginal gyrus. Conclusion： Progressive grey matter atrophy will also exist after the onset of the disease. The pattern of the structural brain changes differs between different stages of disease, and the structural changes of default network is likely to be one of the pathophysiological mechanisms of schizophrenia.</p
