Brain cortex morphology abnormalities in schizophrenic patients with tardive dyskinesia:A magnetic resonance imaging study / 中国心理卫生杂志

ABSTRACT

Objective:To investigate the possible pathological mechanisms of tardive dyskinesia (TD) by analyzing brain cortex morphological changes and it's correlation to abnormal involuntary movement in schizophrenic patients with TD.Methods:Thirty-two schizophrenia patients with TD (TD group),31 schizophrenia patients without TD (non-TD group) and 21 healthy volunteers (control group) were recruited.Combined TD and non TD group into schizophrenia group.The psychopathological symptoms and abnormal involuntary movement were assessed with the Positive and Negative Syndrome Scale (PANSS) and Abnormal Involuntary Movement Scale (AIMS).The brain magnetic resonance imaging (MRI) data and Freesurfer software were used to measure the gray matter volume,cortical thickness,cortical surface area and volume of sub-conical regions among the three groups.Results:Schizophrenia group had significantly smaller gray matter volume in right nucleus accumbens,bilateral hippocampus,left superior frontal gyrus,left precentral sulcus superior part,and cortical surface area in left precentral sulcus superior part than the controls.The TD group had significantly smaller gray matter volume in right nucleus accumbens,larger gyrus gray matter volume and conical surface area in left precentral sulcus superior part than non-TD group (Ps ＜ 0.05).To test the difference between TD and non-TD group further,the chlorpromazine equivalent dose and PANSS negative scores Was controlled,the TD group still had significantly larger gray matter volume and surface area in left precentral sulcus superior part than the non-TD group [(2.03 ±0.07) × 103mm3 vs.(1.68-± 0.07) × 103 mm3,(1.01 ± 0.03) × 103 mm2 vs.(0.84 ± 0.03) × 103 mm2;Ps ＜ 0.05].Correlation analyses showed in schizophrenia group the cortical thickness in right inferior frontal gyrus correlated negatively with PANSS positive and general scores,positively with total scores;cortical volume in left occipital temporal sulcus correlated negatively with PANSS general and total scores,right inferior frontal gyrus correlated positively with PANSS positive scores,right intraparietal sulcus correlated positively with PANSS positive scores.In TD group,the cortical volume in left precentral sulcus superior part correlated positively with AIMS scores (r =0.46,P ＜0.01).Conclusions:The schizophrenia patients with TD had significantly increased gray matter volume and cortical surface area in left precentral sulcus superior part,which suggested there were motion compensation in the left precentral sulcus superior part in the pathogenesis of TD.