首发儿童精神分裂症患者病前行为特征与颅脑结构及认知功能的关系

发布时间：2018-03-11 10:27

本文选题：精神分裂症　切入点：儿章　出处：《新乡医学院》2012年硕士论文　论文类型：学位论文

【摘要】：目的调查首发儿童精神分裂症患者病前行为特征、颅脑结构特征和认知功能,探讨本病病前行为特征与颅脑结构特征及认知功能之间的关系。方法 1.选择102例首发儿童精神分裂症患者作为研究对象。 2.采用Achenbach儿童行为量表(Child Behavior Check-list, CBCL),回顾性调查患者在4～5岁和6～11岁时的行为特征。量表记分项目包括社会能力和行为问题两部分,社会能力记总分,行为问题记总分及七个因子分(分裂强迫、抑郁、体诉、社交退缩、多动、攻击性和违纪)。 3.在磁共振成像(Magnetic resonance imaging, MRI)下测量患者的颅脑结构特征,测量指标包括：三脑室横径、三脑室侧壁至左右脑岛面距、侧脑室前角间距、侧脑室体最大距、左右颞角宽度、左右外侧裂脑沟根部宽、额叶脑沟宽、顶叶脑沟宽、纵裂宽度、左右尾状核头宽度和胼胝体厚度。 4.用事件相关电位(Event-related Potentials, ERP) P300和探究性眼动分析(exploratory eye movement, EEM)评估患者的认知功能,P300的评估指标包括潜伏期和波幅,EEM的评估指标包括凝视点数(number of eye fixations, NEF)和反应性探索评分(responsive search score, RSS)。 5.用t检验比较CBCL量表各因了高分组与低分组患者之间颅脑结构测量值及治疗前后P300及EEM各数据之间的差别,用协方差分析比较CBCL量表各因子高分组与低分组患者之间颅脑结构测量值的差异,用Pearson相关分析分析CBCL量表各因子分、颅脑结构测量值、治疗前后P300及EEM指标各数据之间的相互关系。结果 1.CBCL量表社会能力与颅脑结构及认知功能的关系： (1)社会能力与颅脑结构的关系：在4-5岁年龄段,社会能力总分与胼胝体厚呈正相关(r=0.253,P0.05)；在6-11岁年龄段,社会能力总分与右颞角宽度呈正相关(r=0.345,P0.01)；在4-5岁和6-11岁两个年龄段,社会能力总分均与顶叶脑沟宽呈负相关(r=-0.253,-0.273,P0.05)。 (2)社会能力与认知功能的关系：在4～5岁和6-11岁两个年龄段,社会能力总分均与治疗前P300潜伏期呈负相关(r=-0.215,-0.231；P0.05)。 2. CBCL量表行为问题与颅脑结构及认知功能的关系： (1)行为问题与颅脑结构的关系：在4-5岁年龄段,分裂强迫因子分与侧脑室前角间距呈正相关(r=0.316,P0.05),抑郁因子分、体诉因子分、社交退缩因子分及行为问题总分与右外侧裂脑沟根部宽呈正相关(r=0.347,0.278,0.289,0.309：P0.05,P0.01)。在6-11岁年龄段,分裂强迫因子分、抑郁因子分与三脑室横径呈中相关(r=0.301,0.264；P0.05),行为问题总分与胼胝体厚呈负相关(r=-0.252,P0.05)。在4-5岁和6～11岁两个年龄段,攻击性因子分均与胼胝体厚呈负相关(r=-0.291,-0.323：P0.05,P0.01)。 (2)行为问题与认知功能的关系：在4-5岁年龄段,抑郁因子分与治疗前RSS呈负相关(r=-0.246,P0.05)；在6-11岁年龄段,行为问题总分与治疗前NEF呈负相关(r=-0.227,P0.05)。在4-5岁和6-11岁两个年龄段,社交退缩因子分均与治疗前NEF呈负相关(r=-0.225,-0.344；P0.05,P0.01)。 3.颅脑结构与认知功能的关系纵裂宽度与治疗后P300潜伏期呈正相关(r=0.315,P0.05),额叶脑沟宽与治疗后P300波幅呈负相关(r=-0.353,P0.05)。结论 1.首发儿童精神分裂症患者病前社会能力与行为问题均与颅脑结构存在相关关系,社会能力越低,行为问题越多,脑室扩大和脑结构异常越明显。 2.首发儿童精神分裂症患者病前社会能力与行为问题均与认知功能存在相关关系,社会能力越低,行为问题越多,认知功能损害越严重。 3.首发儿童精神分裂症患者颅脑结构与认知功能之间存在相关关系,脑室扩大和脑结构异常越明显,认知功能损害越严重。
[Abstract]:objective
To investigate the preclinical behavioral characteristics, cranial structure and cognitive function of the first onset children with schizophrenia, and to explore the relationship between premorbid behavioral characteristics and brain structural characteristics and cognitive function.
Method
1. the subjects of 102 schizophrenic children were selected as the research subjects.
2. with the Achenbach Child Behavior Checklist (Child Behavior, Check-list, CBCL), a retrospective survey of patients in the 4~5 and 6~11 years of age characteristics. The two part points the project scale including the social ability and behavior problems, social behavior problems on ability to remember scores, total score and seven factors (the splitting of compulsion, depression, body v., social withdrawal, hyperactivity, aggression and discipline).
3. in the magnetic resonance imaging (Magnetic resonance, imaging, MRI) brain structure were measured, the measurement indicators include: the three ventricle diameter, three ventricle wall surface distance to the left and right insula, anterior horn of lateral ventricle spacing, lateral ventricle maximum distance, about the width of the temporal horn, left and right lateral sulcus width split root the frontal sulci, parietal lobe width, groove width, slit width, right caudate head width and thickness of the corpus callosum.
4. by event related potentials (Event-related Potentials, ERP P300) and exploratory eye movement (exploratory eye, movement, EEM) to evaluate the cognitive function of patients, evaluation index including P300 latency and amplitude, the evaluation index of EEM (number of eye including gaze points fixations, NEF) and responsive search score (responsive search score. RSS).
5. using t test to compare CBCL scale factors between high score and low score in patients with brain structure measurements before and after treatment of P300 and EEM and the difference in the data, analysis and comparison of CBCL scale differences between the various factors of the high score and low score in patients with brain structure measurement value by analysis of covariance, CBCL scale factors using Pearson correlation analysis, brain structure measurement, the relationship between P300 and EEM index data before and after treatment.
Result
The relationship between the social ability of the 1.CBCL scale and the craniocerebral structure and cognitive function:
(1) the relationship between social competence and brain structure: in 4-5 years of age, total score and social ability were positively related to corpus callosum body thickness (r=0.253, P0.05); in 6-11 years of age, social ability score and the right width of the temporal horn was positively correlated (r=0.345, P0.01); in the 4-5 and 6-11 year old age of two social competence scores are, and parietal lobe groove width was negatively correlated (r=-0.253, -0.273, P0.05).
(2) the relationship between social function and cognitive function: the total score of social ability was negatively correlated with the latent period of P300 before treatment (r=-0.215, -0.231; P0.05) at 4~5 and 6-11 years old two age groups.
The relationship between the behavior problems of the 2. CBCL scale and the craniocerebral structure and cognitive function:
(1) the relationship between behavior problems and brain structure: in 4-5 years of age, forced split factors with the anterior horn of the lateral ventricle spacing was positively correlated (r=0.316, P0.05), depression factor score, body action factor scores, social withdrawal scores and behavior problems score and right lateral root width was positively related to brain sulcus (r=0.347,0.278,0.289,0.309:P0.05, P0.01). In 6-11 years of age, split forcing factor, depression factor scores and the three ventricle diameter was related (r=0.301,0.264; P0.05), the total score of CBCL was negatively correlated with the corpus callosum thickness (r=-0.252, P0.05). At the age of 4-5 and 6~11 years old in two age, aggressive factor scores were the corpus callosum was negatively correlated with thickness (r=-0.291, -0.323:P0.05, P0.01).
(2) the relationship between function and cognitive behavior: in 4-5 years of age, depression factor score before treatment with RSS showed a negative correlation (r=-0.246, P0.05); in 6-11 years of age, behavior problems score and NEF before treatment were negatively correlated (r=-0.227, P0.05). In the 4-5 and 6-11 year old age two section, social withdrawal factor scores were negatively correlated with before treatment NEF (r=-0.225, -0.344; P0.05, P0.01).
3. the relationship between craniocerebral structure and cognitive function
There was a positive correlation between the width of the longitudinal fissure and the latent period of P300 after treatment (r=0.315, P0.05). The width of the frontal lobe was negatively correlated with the amplitude of the P300 wave after treatment (r=-0.353, P0.05).
conclusion
1., the social ability and behavior problems of the first onset children with schizophrenia were correlated with the brain structure. The lower the social competence, the more behavioral problems, the more obvious the ventricular enlargement and the brain structural abnormalities.
2., the onset of children's schizophrenia and social function and behavioral problems are all related to cognitive function. The lower social competence, the more behavioral problems, the more serious the cognitive impairment is.
3., there is a correlation between cranial structure and cognitive function in the first onset children with schizophrenia. The greater the ventricular enlargement and the more abnormal brain structure, the more serious the cognitive impairment is.

【学位授予单位】：新乡医学院
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R749.3

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