分裂型人格障碍内嗅皮层神经纤维概率追踪的DTI研究

发布时间：2018-07-08 19:26

本文选题：分裂型人格障碍 + 功能核磁共振　；参考：《大连医科大学》2014年硕士论文

【摘要】：目的通过随机对照研究，探讨年龄为19-21的青春后期分裂型人格障碍者和健康对照组之间大脑白质的差异。为了发现分裂症系谱早期阶段可能存在的白质病变部位，进行概率追踪比较两组被试右侧内嗅皮层与额叶间神经纤维束连接差异。对象某大学3500名一年级男生在知情同意的情况下，接受了MMPI筛查，筛出精神病质（Sc）分大于等于70分的75名个体，他们进一步的接受了分裂型人格障碍调查问卷（SPQ），同时接受了DSM-IV诊断，最终50名男生被作为研究对象（分裂型人格障碍组），从中随机抽取18名作为大脑白质纤维研究对象；同时随机抽取MMPI人格正常健康的个体18名作为对照组。方法 36名被试在知情同意情况下，接受了德国GE3.0特斯拉的核磁共振扫描仪的扫描，被试的DTI图像被采集，，用配对样本t检验比较了两组人群脑白质的FA值的差异；差异部位的FA值与SPQ分值之间的相关通过Pearson相关分析方法完成；两组间差异部位（内嗅皮层）到额叶的白质纤维追踪通过概率分析完成，比较了两组被试内嗅皮层—额叶皮层间连接的概率差异。结果 1）与健康对照组相比，分裂型人格障碍的被试（SPD）的FA值在右侧颞叶（内嗅皮质）白质密度倾向高于对照组（P=0.09）；2）有差异趋向区的FA值与分裂型人格问卷中的阳性因子中偏执分呈显著负相关（r=-0.486, P=0.042）；FA值和分裂型人格问卷中阳性总分呈有意义的负相关（r=-0.525, p=0.025）；FA值与分裂型人格问卷中的阴性维度中的过度焦虑分呈显著负相关（r=-0.53, p=0.024）。3）患有分裂型人格障碍的被试的MMPI的Sc分与分裂型人格问卷（SPQ）的阳性因子的怪异行为维度分呈显著正相关（r=0.481, p=0.043）；Sc分也与阳性因子中的不寻常的感知觉体验呈显著正相关(r=0.517,p=0.028)；Sc分与阳性维度中的偏执观念呈显著正相关（r=0.517，p=0.028）；Sc分与SPQ问卷的阳性症状总分呈显著正相关（r=0.472, p=0.048）；4）分裂型人格障碍被试的右侧内嗅皮层到脑额叶的神经纤维连接概率高于对照组，差异显著，p0.05。结论分裂型人格障碍组大脑白质纤维密度，在右侧颞叶区域（内嗅皮层）趋向高于对照组；说明SPD组右侧内嗅皮质的白质纤维密度越高，内嗅皮层传到额叶的白质纤维束的连接概率也越高，而且右侧内嗅-额叶纤维白质的增加可能对于阳性症状的偏执、阴性症状的焦虑负有责任。
[Abstract]:Objective to investigate the difference of white matter between the 19-21 age group with split personality disorder and the healthy control group in a randomized controlled study. In order to find the possible white matter lesions in the early stage of pedigree of schizophrenia, the difference of nerve fiber bundle connections between the right olfactory cortex and frontal lobe in the two groups was compared by probabilistic tracing. Participants 3500 first-year male students in a certain university were screened with MMPI with informed consent, and 75 individuals with a score of more than 70 (SC) were screened. They further received the split personality disorder questionnaire (SPQ) and DSM-IV diagnosis. Finally, 50 male students were selected as the subjects of the study (split personality disorder group), and 18 subjects were randomly selected from the middle of the study as the white matter fiber study subjects. At the same time, 18 individuals with normal MMPI personality were randomly selected as control group. Methods 36 subjects were scanned by GE 3.0 Tesla nuclear magnetic resonance scanner with informed consent, and the difference of FA values in white matter between the two groups was compared with paired t-test. The correlation between FA value and SPQ score was completed by Pearson correlation analysis, and the white matter fibers from the different sites (endolfactory cortex) to frontal lobe were tracked by probability analysis. The probabilities of the connection between olfactory cortex and frontal cortex were compared between the two groups. Results 1) compared with the healthy control group, the FA value of the subjects with split personality disorder (SPD) was higher than that of the control group in the right temporal lobe (endoolfactory cortex) (P < 0.09). 2) there was a significant negative correlation between FA value of different tendency area and paranoid score of positive factor in split personality questionnaire (r-0.486, P0. 042). There was significant negative correlation between FA value and positive total score in split personality questionnaire (r-0.525, p0. 025). There was a significant negative correlation between FA value and the scores of excessive anxiety in the negative dimension of the split personality questionnaire (r-0.53, p0. 024). 3. The SC score of MMPI of subjects with split personality disorder and the weird behavioral dimension of positive factors of split personality questionnaire (SPQ) were significantly negatively correlated with FA value (r-0.53, p0. 024). There was a significant positive correlation (r = 0.481, p = 0.043). The SC score was also positively correlated with the abnormal perceptual experience in the positive factors (rn 0.517 p0. 028) and the paranoid perception in the positive dimension (r 0. 517 p0. 028) SC score was significantly positively correlated with the total score of positive symptoms in SPQ questionnaire (r0. 472, p0. 048), and there was a significant positive correlation between SC score and the total score of positive symptoms in the SPQ questionnaire (r0. 472, p0. 048). 4) the probability of nerve fiber connection from the right olfactory cortex to the frontal lobe of the patients with split personality disorder was higher than that of the control group, and the difference was significant (p 0.05). Conclusion the density of white matter fibers in the right temporal lobe (entorhinal cortex) in the split personality disorder group was higher than that in the control group, indicating that the density of the white matter fiber in the right olfactory cortex of SPD group was higher than that of the control group. The higher the connection probability of the white matter fiber bundle from the endoolfactory cortex to the frontal lobe, and the increase of the white matter in the right endolfactory and frontal lobe may be responsible for the paranoia of positive symptoms and anxiety of negative symptoms.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：B845

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