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目的调查精神分裂症患儿颅脑结构异常和认知功能的关系。方法选择55例首发精神分裂症患儿和39名健康儿童为研究对象,利用MRI进行颅脑结构测量,用《中国修订韦氏儿童智力量表手册》(C-WISC)评估其认知功能。结果 1.精神分裂症患儿第三脑室横径、侧脑室前脚间距、左右颞角宽度、左右外侧裂脑沟根部宽、额叶和顶叶脑沟宽均高于健康对照组(Pa<0.05),胼胝体厚低于健康对照组(P<0.05);2.精神分裂症患儿第三脑室横径与常识、领悟、算术、数字广度、言语总分、言语智商(VIQ)、全量表分及全量表智商(FIQ)均呈负相关(Pa<0.05),第三脑室侧壁至左右脑岛面距、侧脑室前脚间距、侧脑室体最大距与常识均呈负相关(Pa<0.05),左右颞角宽度与常识、算术、言语总分、VIQ、全量表分及FIQ均呈负相关(Pa<0.05),左右外侧裂脑沟根部宽与常识、算术、数字广度、言语总分、VIQ、全量表分及FIQ均呈负相关(Pa<0.05),额叶脑沟宽与算术、言语总分及VIQ均呈负相关(Pa<0.05),顶叶脑沟宽与常识、算术、言语总分及VIQ均呈负相关(Pa<0.05),胼胝体厚与常识呈正相关(P<0.05)。结论精神分裂症患儿存在显著的脑室扩大和脑结构异常,脑室扩大和脑结构异常与认知损害存在相关关系,脑室扩大和脑结构异常越明显,认知损害越严重。
Objective To investigate the relationship between brain structural abnormalities and cognitive function in children with schizophrenia. Methods Fifty-five children with first-episode schizophrenia and 39 healthy children were enrolled in this study. Their brain structures were measured by MRI, and their cognitive function was evaluated by C-WISC (Chinese Revision of Wechsler Children’s Intelligence Scale). Children with schizophrenia in the third ventricle diameter, lateral ventricle forefoot spacing, left and right temporal angle width, left and right lateral cleft lip groove width, frontal lobe and parietal lobe sulcus width were higher than the healthy control group (Pa 0.05 ), Corpus callosum thickness lower than the healthy control group (P <0.05); 2 children with schizophrenia third ventricle diameter and common sense, comprehension, arithmetic, digital breadth, verbal total score, verbal IQ (VIQ) (P <0.05). There was a negative correlation between the distance from the side wall of the third ventricle to the left and right insular island, the anteroseptal distance of the lateral ventricle and the maximum distance of the lateral ventricle body (P <0.05) , Left and right temporal width and common sense, arithmetic, total score, VIQ, total score and FIQ were negatively correlated (Pa <0.05), left and right lateral cracked sulci width and common sense, arithmetic, digital breadth, (P <0.05). The width of frontal lobe was negatively correlated with arithmetic, verbal total score and VIQ (P <0.05). The width of parietal lobe and common knowledge, arithmetic, The verbal total score and VIQ were negatively correlated (Pa <0.05), and corpus callosum thickness was positively correlated with common sense (P <0.05). Conclusions There are significant ventricular enlargement and abnormal brain structure in children with schizophrenia. There is a correlation between enlarged ventricles and abnormal brain structure and cognitive impairment. The more obvious ventricular enlargement and abnormal brain structure are, and the more severe the cognitive impairment is.