Objective: To analyze the relationship of gray matter volume and cortical thickness of auditory verbal hallucination in first-episode childhood-onset schizophrenia(COS). Methods: Sixty cases of first-episode childhood-onset schizophrenia who were treated in the inpatient department of the Second Affiliated Hospital of Xinxiang Medical University from October 2020 to February 2024 were collected(case group).Thirty-two healthy students from a primary and secondary school in Xinxiang city were the control group. According to the score of "auditory hallucination" on the positive symptoms scale (SAPS), the patients were divided into the non-auditory hallucination group(nAVH) (n=16, score 0-1) and the auditory hallucination group (AVH)(n=38, score 2-5). The severity of psychiatric symptoms of patients was evaluated using Positive And Negative Syndrome Scale (PANSS). Resting-state MRI data was scanned for all subjects. REST software and FreeSurfer software was used for covariance analysis of gray matter volume and cortical thickness.Age and gender as covariates. Results: Finally, 54 case groups were included, including 16 cases in the non-auditory hallucination group, there were 8 males and 8 females, with an age of (12.9±1.7) years; in the auditory hallucination group, there were 16 males and 22 females, with an age of (13.1±1.5) years.There were Control group of 27 cases, 12 males, 15 females, with an age of (12.2±1.5) years. In the covariance analysis of gray matter volume showed that the brain regions with differences were mainly located in the left parahippocampal gyrus, cingulate gyrus, superior temporal gyrus, inferior frontal gyrus, superior temporal gyrus, occipital lobe, precentral gyrus, inferior parietal gyrus; Right superior frontal gyrus, lingual gyrus, fusiform gyrus, transverse temporal gyrus, inferior temporal gyrus, superior temporal gyrus(P<0.05, FDR correction).Post hoc tests found that compared with the control group, the cerebral areas with decreased gray matter volume in the AVH group were mainly located in the left superior temporal gyrus, hippocampus, cingulate gyrus, middle temporal gyrus, insula, inferior frontal gyrus;right superior temporal gyrus, superior frontal gyrus, supramargal gyrus and transverse temporal gyrus(P<0.05, FDR correction). In the covariance analysis of Cortical Thickness showed that the brain regions with differences were mainly located in the left inferior parietal gyrus, middle temporal gyrus, anterior central gyrus, supramarginal gyrus, transverse temporal gyrus, Lateral orbitofrontal cortex, insular lobe, anterior cingutate, precuneus, right superior temporal gyrus, cuneiform gyrus, middle frontal gyrus(P<0.05, FDR correction).Post hoc tests found that compared with the control group, the cerebral areas with decreased cortical thickness in the the left postcentral gyrus, transverse temporal gyrus, lateral orbitofrontal cortex, superior frontal gyrus, superior temporal gyrus, insular lobe; right cuneiform gyrus, superior temporal gyrus, supramarginal gyrus, middle temporal gyrus.The increased cortical thickness was found in the right anterior cingulate(P<0.05,FDR corrected). the nAVH group showed decreased cortical thickness areas mainly located in the left inferior temporal gyrus, inferior parietal gyrus, lateral orbitofrontal cortex, superior frontal gyrus, postcentral gyrus; right cuneiform gyrus, middle temporal gyrus, precentral gyrus. The rest showed no obvious abnormality, and the differences were statistically significant (P<0.05, FDR corrected). Conclusions: The decreased gray matter volume and cortical thickness is found in multiple brain regions in with or without auditory verbal hallucination in first-episode childhood-onset schizophrenia. Consequently, abnormal gray matter structure may be associated with the pathogenesis of childhood schizophrenia.The abnormal structure of the left and right superior temporal grrus, right supramarginal gyrus, right anterior cingulate cortex may be related to the mechanism of auditory hallucination.
目的： 分析首发儿童精神分裂症幻听与脑灰质体积及皮质厚度的关系。 方法： 回顾性纳入自2020年10月至2024年2月期间在新乡医学院第二附属医院病房住院的60例首发儿童精神分裂症患者（病例组）和32名新乡市某中小学的健康在校学生（对照组）。按照阳性症状评分量表（SAPS）中的“听幻觉”评分，将病例组分为无幻听组16例（0~1分）、幻听组38例（2~5分）。用阳性与阴性症状量表（PANSS）评估所有患者的精神症状。对所有研究对象进行静息态MRI数据扫描，使用REST软件和FreeSurfer软件分别对灰质体积及皮质厚度进行协方差分析，用年龄和性别做协变量。 结果： 最终纳入病例组54例，其中无幻听组16例，男8例，女8例；年龄（12.9±1.7）岁；幻听组38例，男16例，女22例，年龄（13.1±1.5）岁。对照组27名，男12名，女15名，年龄（12.2±1.5）岁。对灰质体积进行协方差分析发现，存在差异的脑区主要位于左海马旁回、扣带回、颞上回、额下回、颞下回、枕叶、中央前回、顶下叶，右额上回、舌回、梭状回、颞横回、颞下回、颞上回［均P<0.05，错误发现率（FDR）矫正］。事后检验发现，与对照组比较，幻听组灰质体积降低的脑区主要位于左颞上回、海马、扣带回、中央前回、脑岛、额下回，右颞上回、额上回、缘上回、颞横回（均P<0.05，FDR矫正）。对皮质厚度进行协方差分析发现，存在差异脑区主要位于左顶下回、颞中回、中央前回、缘上回、颞横回、外侧眶额叶皮质、岛叶、前扣带回、楔前叶，右颞上回、楔状回、额中回（均P<0.05，FDR矫正）。事后检验发现，与对照组比较，幻听组皮质厚度减低的脑区主要位于左中央后回、颞横回、外侧眶额叶皮质、额上回、颞上回、岛叶，右楔状回、颞上回、缘上回、颞中回；皮质厚度增加的脑区为右前扣带回（均P<0.05，FDR矫正）。非幻听组皮质厚度减低的脑区主要位于左颞下回、顶下回、外侧眶额叶皮质、额上回、中央后回，右楔状回、颞中回、中央前回，差异均有统计学意义（均P<0.05，FDR矫正）。 结论： 首发儿童精神分裂症伴与不伴幻听的患者均存在多个脑区灰质体积及皮质厚度的减低，提示脑灰质结构异常可能与儿童精神分裂症的发病机制有关。左右侧颞上回、右缘上回、右前扣带回脑区结构异常可能与患者幻听的发生机制有关系。.