目的:淋巴系统(GS),大脑废物清除途径,在各种神经退行性疾病和血管疾病中受到破坏。由于精神分裂症与这些疾病具有共同的临床特征,我们假设精神分裂症谱系障碍(SCZ-SD)患者的GS中断,反映在沿血管周围间隙(DTI-ALPS)指数的脑大分子(MM)增加和弥散张量图像分析减少。
方法:研究了47例健康对照(HCs)和103例SCZ-SD患者。数据包括135个质子磁共振波谱(1H-MRS)集,96套DTI,79名参与者都有贡献。在背前扣带皮质(dACC)中量化MM水平,背外侧前额叶皮质,和背尾状(点分辨光谱学,回声时间=35ms)。测量侧脑室附近的投影和缔合纤维的扩散系数以计算DTI-ALPS指数。进行了一般的线性模型,调整年龄,性别,和吸烟。相关分析检查了与年龄的关系,疾病持续时间,和症状严重程度。
结果:MM水平在患者和HCs之间没有差异。然而,左,对,与HCs相比,患者的双侧DTI-ALPS指数较低(P<0.001)。在HC中,年龄与dACCMM呈正相关,与左侧呈负相关,对,和双边DTI-ALPS指数(P<.001)。在患者中,病程与dACCMM呈正相关,与右DTI-ALPS指数呈负相关(P<0.05)。在整个人口中,dACCMM和DTI-ALPS指数呈负相关(P<0.01)。
结论:我们的研究结果提示SCZ-SD患者的GS有潜在的破坏。改善脑废物清除可能为SCZ-SD患者提供一种潜在的治疗方法。
OBJECTIVE: The glymphatic system (GS), a brain waste clearance pathway, is disrupted in various neurodegenerative and vascular diseases. As schizophrenia shares clinical characteristics with these conditions, we hypothesized GS disruptions in patients with schizophrenia spectrum disorder (SCZ-SD), reflected in increased brain macromolecule (MM) and decreased diffusion-tensor-image-analysis along the perivascular space (DTI-ALPS) index.
METHODS: Forty-seven healthy controls (HCs) and 103 patients with SCZ-SD were studied. Data included 135 proton magnetic resonance spectroscopy (1H-MRS) sets, 96 DTI sets, with 79 participants contributing both. MM levels were quantified in the dorsal-anterior cingulate cortex (dACC), dorsolateral prefrontal cortex, and dorsal caudate (point resolved spectroscopy, echo-time = 35ms). Diffusivities in the projection and association fibers near the lateral ventricle were measured to calculate DTI-ALPS indices. General linear models were performed, adjusting for age, sex, and smoking. Correlation analyses examined relationships with age, illness duration, and symptoms severity.
RESULTS: MM levels were not different between patients and HCs. However, left, right, and bilateral DTI-ALPS indices were lower in patients compared with HCs (P < .001). In HCs, age was positively correlated with dACC MM and negatively correlated with left, right, and bilateral DTI-ALPS indices (P < .001). In patients, illness duration was positively correlated with dACC MM and negatively correlated with the right DTI-ALPS index (P < .05). In the entire population, dACC MM and DTI-ALPS indices showed an inverse correlation (P < .01).
CONCLUSIONS: Our results suggest potential disruptions in the GS of patients with SCZ-SD. Improving brain\'s waste clearance may offer a potential therapeutic approach for patients with SCZ-SD.