Brain Structure Abnormalities In Paranoid Personality Disorder:A Combined DTI With VBM Study

Objective: 1.To find differences in fractional anisotropy(FA),mean diffusivity(MD),radial diffusivity(RD),axial diffusivity(AD)between young adult males with paranoid personality disorder(PPD)and healthy controls(HCs).2.To find Gray matter voxel based morphometry(VBM)differences between paranoid personal disorder individuals and healthy controls at baseline assessment.3.This study attempts to explore the brain structural changes and connection abnormalities associated with paranoid personality disorder by combining the VBM with TBSS.Subjects: We selected 2300 young adult males from Universities of Dalian,all of them filled in Minnesota Multiphasic Personality Inventory(MMPI)under the circumstance of informed consent,We made a differential diagnosis of them through the fifth edition of Diagnostic and Statistical Manual of Mental Disorders(DSM-V)by two experienced psychiatrists,then we finally got 17 young adult males with PPD as the Subjects of this study.and selected 17 age(18-22),level of education matched young males without PPD as our healthy controls.Methods: We examined all of 34 participants using SIEMENS 3.0 Tesla superconducting magnetic resonance scanning imaging system,and acquired all the experiment subjects? diffusion tensor imaging data and T1 imaging data.By using Tract-based spatial statistic,we compared whether there are exist differences between PPD individuals and healthy controls in white matter fibers.By using voxel based morphometry,we compared whether there are exist differences between PPD individuals and healthy controls in gray matter volume.By using Pearson correlation analysis,we analyzed whether there are exist any correlation between FA values,MD values,RD values,AD values of all divergence brain regions of PPD individuals and the Pa factor scores of MMPI.Results: 1.There was no significant difference between the PPD individuals and health controls in age and education(p>0.05).2.Compared with healthy controls,PPD individuals showed decreased fractional anisotropy(FA)in the body of corpus callosum,genu of corpus callosum,right cingulate,left superior longitudinal fasciculus,bilateral posterior thalamus radiation(include optic radiation)and bilateral superior corona radiata,bilateral posterior corona radiata,bilateral anterior corona radiata(p < 0.01),Compared with healthy controls,We have not find any increased fractional anisotropy(FA)of brain regions in PPD individuals.Compared with healthy controls,PPD individuals showed increased mean diffusivity(MD)in the splenium of corpus callosum,bilateral superior longitudinal fasciculus,right posterior thalamus radiation(include optic radiation),right superior corona radiata,bilateral posterior corona radiata(p < 0.04).Compared with healthy controls,PPD individuals showed increased radial diffusivity(RD)in the splenium of corpus callosum,genu of corpus callosum,bilateral superior longitudinal fasciculus,right posterior thalamus radiation(include optic radiation),and bilateral posterior corona radiata,bilateral superior corona radiata(p < 0.01).There was no significant difference in AD value between PPD individuals and health controls.3.Compared with healthy controls,PPD individuals showed reduction of gray matter volume in left dorsolateral prefrontal cortex.(p <0.001).PPD individuals showed increased gray matter volume in right precuneus(p <0.001).4.In this study,the FA value of all divergence brain regions obtained by the use of the TBSS was significantly negatively correlated with the Pa factor scores of MMPI(p <0.05).There was a significant negative correlation(p <0.001)between the GMV of left dorsolateral prefrontal cortex and the Pa factor scores of MMPI.The GMV of right precuneus was positively correlated with the Pa factor scores of MMPI(p <0.001).Conclusion: In this study,we using diffusion tensor imaging technique,taking TBSS analysis tool,found that abnormal white matter microstructure of PPD individuals in corpus callosum,cingulate,superior longitudinal fasciculus,corona raiata and thalamic radiation,And combines the technique of VBM,found that compared with the healthy controls,PPD individuals showed significantly reduction of grey matter volume in prefrontal lobe,precuneus cortex regional gray matter volume increased significantly.Abnormalities in these brain regions may be one of the neuropathological foundations of the onset of male paranoid personality disorder.The abnormalities in gray matter and white matter of the brain already exists in the youth stage.