Comparison Of White-matter Integrities Between Schizophrenic Patients Maintained Treated With Chlorpromazine And Clozapine

Objective To examine the different white-matter integrities by tract-based spatial statistics between schizophrenic patients maintained treated with chlorpromazine and clozapine.Methods The patients with schizophrenia in stable condition that received maintenance treatment with chlorpromazine and clozapine and normal control subjects were recruited (n=24 per groups). The patients have been evaluated on positive and negative symptoms scale, the scale of social function for assessment of hospitalized psychiatric patients and their cognitive functions. All participants are scanned by GE HDx 3.0T made in the United States for diffusion tensor image. First, the white matter integrities were analyzed by spatial statistics method based on fiber tracer and expolored its correlation with clinical symptoms and cognitive function among the three groups. Then the present paper continues to analyze the corelations among different white matter fiber tracts, clinical symptoms and cognitive function.Results There was no significant differences of positive and negative symptoms scale, the scale of social function for assessment of hospitalized psychiatric patients and their cognitive functions. Compared with the control group, the two patient groups showed cognitive impairment including executive function, information processing speed, memory and attention (p<0.05).The results of cerebral white matter map are as follows:There was no remarkably different parameter value of diffusion tensorimage between the two patient groups.* Fractional anisotropy:compared with the control group, the two patient groups displayed decreased anisotropic scores in bilateral anterior thalamic radiation, occipital and frontal corpus callosum, inferior fronto-occipital fasciculus and left inferior fasciculi longitudinalis. And in the clozapine patient group has lower socres of the anisotropic in superior fasciculi longitudinalis.* Axial diffusivity:Compared with the control group, the increased axial dispersion rate had been found in bilateral anterior thalamic radiation, occipital and frontal corpus callosum, inferior fronto-occipital fasciculus, left uncinatefasciculus and right inferior fasciculi longitudinalis. And the clozapine patient group also displayed increased axial dispersion rate in bilateral corticospinal tract, frontal corpus callosum, inferior fronto-occipital fasciculus, left inferior fasciculi longitudinalis and superior fasciculi longitudinalis.* Radial diffusivity:Compared with the control group, the increased axial dispersion rate had been found in bilateral anterior thalamic radiation, occipital and frontal corpus callosum, inferior fronto-occipital fasciculus, left uncinated fasciculus and right inferior fasciculi longitudinalis in the two patient groups. And the clozapine patient group also displayed increased axial dispersion rate in bilateral cingulum, left hippocampus and inferior fasciculi longitudinalis.*Mean diffusivity:Compared with the control group, the two patient groups displayed increased average rate of dispersion in bilateral anterior thalamic radiation, left corticospinal.tract, frontal corpus callosum, bilateral inferior fronto-occipital fasciculus, left hippocampus, uncinated fasciculus and right inferior fasciculi longitudinalis. And the clozapine patient group also displayed increased axial dispersion rate in bilateral cingulum, right inferior fasciculi longitudinalis and left superior fasciculi longitudinalis.* Partial correlation:The FA values of bilateral anterior thalamic radiation, occipital and frontal corpus callosum, inferior fronto-occipital fasciculus and left inferior fasciculi longitudinalis were positively correlated with category scores, STROOP words, STOOP color points, STOOP color word interference scores and total scores of space. The FA values of left superior fasciculi longitudinalis were negatively correlated with general psychopathology scale points, the PANSS scores and negative inventory scores. The FA values of occipital corpus callosum were negatively correlated with PANSS scores.The results from spatial statistical method of fiber tracer are as follows:There was no different parameter value of diffusion tensor image between the two patient groups.* Fractional anisotropy:Compared with the control group, the anisotropic scores of are obviously decreased in parts of body and genu corpus callosum, left cingulum, and right corona radiate in the chlorpromazine groups. And also the anisotropic scores were significantly reduced in parts of body, genu and splenium corpus callosum, bilateral cingulum, corona radiate, posterior thalamic radiation and left superior fasciculi longitudinalis in the clozapine groups.* Axial diffusivity:The clozapine group showed significantly higher axial dispersion rate compared with the normal scale.* Radial diffusivity:The clozapine group showed significantly increased radial diffusion rate compared with the control group.* Mean diffusivity:The clozapine group showed significantly increased average rate of dispersion compared with the control group.* Partial correlation:The FA value of posterior thalamic radiation was negatively correlated with positive points of PANSS.Conclusion Schizophrenic patients have deficits of white-matter integrities in the period of maintenance treatment. The severer impairments of white-matter integrities in clozapine treated patients might be one of pathological mechanism underlying their refractory symptoms.