青少年双相障碍的脑结构和功能磁共振研究
发布时间：2018-07-22 15:40
【摘要】：目的：儿童青少年双相障碍(PBD)是一种严重的退化性的疾病,以反复发作的躁狂和抑郁症状为特征。早期的磁共振(MRI)研究主要研究PBD的情感或认知相关脑区的改变。很少有研究探索PBD患儿的情感-认知双神经环路。我们的实验是为了探知PBD患者的异常情感-认知双神经环路,并研究是否随着疾病的缓解脑区活性也随之改变。 研究方法：我们的研究主要分为三部分。 1.PBD患者结构磁共振的研究。实验包含了躁狂相18人、缓解相15人和对照组18人。 2.PBD患者任务态磁共振的研究。我们运用情绪性go/nogo的任务。此任务中运用的情绪面孔来自于Ekman的1976年编制的部分情绪面孔。所选面孔进行了健康青少年识别率的测试。任务态磁共振研究包含了躁狂相15人、缓解相13人和对照组15人。 3.PBD患者静息态磁共振的研究。我们运用了局部一致性(Regional Homogeneity, ReHo)的方法。实验包括了躁狂相19人、缓解相17人和对照组19人。 结果：1.结构磁共振研究结果发现三组方差分析有左侧海马、海马旁回、杏仁核的体积差异。两样本下t检验的结果显示青少年双相障碍躁狂相和缓解相相比对照组都有左侧海马、海马旁回、杏仁核的体积减少；而躁狂相相比缓解相没有明显的组间差异。同时,没有发现躁狂期和缓解期患者的年龄、病程、发病次数与左侧海马、海马旁回、杏仁核的体积大小有相关性。 2.任务态磁共振的结果。情绪性干扰因素相比中性干扰因素,方差结果显示三组间有活性差异的脑区为：双侧额上回、双侧背中央前额皮质、左侧背侧前额皮质、双侧中下眶额皮质、右腹侧前扣带回、左背侧前扣带回、右侧后扣带回、双侧上中颞叶、右侧壳核、双侧脑岛、双侧海马、左侧海马旁回、双侧丘脑、双侧上下顶叶、双侧楔叶和楔前叶和双侧中下枕回。进行方差限定下两样本t检验的分析得出,躁狂相对比缓解相显示左侧背侧前额皮质和左侧上顶叶有更高活性。 3.静息态磁共振方差结果显示三组间有ReHo值有差异的脑区为：右侧额上回、右侧中央前回、右侧眶额皮质、右侧背侧前扣带回、双侧上颞叶、双侧脑岛、双侧上顶叶和双侧楔前叶。进行方差限定下两样本t检验的分析得出,躁狂相相比缓解相ReHo值减小的脑区有：双侧楔前叶；ReHo值增大的脑区有双侧脑岛。 结论：我们的研究从多个角度发现PBD腹侧-情感和背侧-认知环路的异常,为阐明PBD的病理生理基础提供了新的视角。图17幅,表19个,参考文献382篇
[Abstract]:Objective: bipolar disorder (PBD) in children and adolescents is a severe degenerative disease characterized by recurrent mania and depression. Early magnetic resonance imaging (MRI) studies focused on affective or cognitive-related brain changes in PBD. Few studies have explored the affective-cognitive double neural loop in children with PBD. Our experiment was to detect abnormal affective cognitive double neural loops in PBD patients and to see if the activity of brain regions changed with the remission of the disease. Methods: our study was divided into three parts. 1. Structural MRI study of PBD patients. The study included 18 patients with manic phase, 15 patients with remission phase and 18 patients with control group. 2. We use emotional go/nogo tasks. The emotional faces used in this task came from some emotional faces compiled by Ekman in 1976. The selected faces were tested on the recognition rate of healthy adolescents. The task-based magnetic resonance study included 15 patients in manic phase, 13 in remission phase and 15 in control group. 3. The study of resting magnetic resonance in PBD patients. We use the method of regional homogeneity (ReHo). The experiment included 19 patients with manic phase, 17 patients with remission phase and 19 people with control group. The result is 1: 1. The results of structural magnetic resonance analysis showed that there were differences in volume of left hippocampus, perihippocampal gyrus and amygdala in the three groups. T test under two samples showed that the volume of left hippocampal, para-hippocampal gyrus and amygdala decreased in bipolar disorder manic phase and remission phase, but there was no significant difference in remission phase in manic phase. At the same time, no correlation was found between age, course of disease and frequency of onset in patients with mania and remission with the volume of left hippocampus, perihippocampal gyrus and amygdala. 2. The results of task-based magnetic resonance imaging. Compared with neutral interference factors, the variance of emotional interference factors showed that the brain regions with different activity were bilateral superior frontal gyrus, bilateral dorsal central prefrontal cortex, left dorsal prefrontal cortex, bilateral middle and lower orbital frontal cortex, right ventral anterior cingulate gyrus. Left dorsal cingulate gyrus, right posterior cingulate gyrus, bilateral superior middle temporal lobe, right putamen nucleus, bilateral cerebral island, bilateral hippocampus, left paracarpal gyrus, bilateral thalamus, bilateral superior parietal lobe, bilateral cuneiform lobe and prewedge lobe and bilateral middle and inferior occipital gyrus. T test of two samples under variance limitation showed that mania showed higher activity in the left dorsal prefrontal cortex and left superior parietal lobe than in the remission phase. The results of resting magnetic resonance variance showed that the difference of ReHo value among the three groups was as follows: right superior frontal gyrus, right precentral gyrus, right orbital frontal cortex, right dorsal anterior cingulate gyrus, bilateral superior temporal lobe, bilateral cerebral island. Bilateral superior parietal lobe and bilateral anterior cuneate lobe. The results of t-test of two samples under the limit of variance showed that the decrease of ReHo value in the manic phase compared with that in the remission phase was found in the brain regions with the increase of ReHo value in the bilateral precuneiform lobe and there were bilateral cerebral islands in the brain regions where the value of ReHo in the bilateral precuneial lobe increased. Conclusion: our study found the abnormality of the ventral-affective and dorsal-cognitive loops in PBD from several angles, which provides a new perspective for elucidating the pathophysiological basis of PBD. 17 figures, 19 tables, 382 references
【学位授予单位】：中南大学
【学位级别】：博士
【学位授予年份】：2013
【分类号】：R749.94;R445.2
本文编号：2137938
[Abstract]:Objective: bipolar disorder (PBD) in children and adolescents is a severe degenerative disease characterized by recurrent mania and depression. Early magnetic resonance imaging (MRI) studies focused on affective or cognitive-related brain changes in PBD. Few studies have explored the affective-cognitive double neural loop in children with PBD. Our experiment was to detect abnormal affective cognitive double neural loops in PBD patients and to see if the activity of brain regions changed with the remission of the disease. Methods: our study was divided into three parts. 1. Structural MRI study of PBD patients. The study included 18 patients with manic phase, 15 patients with remission phase and 18 patients with control group. 2. We use emotional go/nogo tasks. The emotional faces used in this task came from some emotional faces compiled by Ekman in 1976. The selected faces were tested on the recognition rate of healthy adolescents. The task-based magnetic resonance study included 15 patients in manic phase, 13 in remission phase and 15 in control group. 3. The study of resting magnetic resonance in PBD patients. We use the method of regional homogeneity (ReHo). The experiment included 19 patients with manic phase, 17 patients with remission phase and 19 people with control group. The result is 1: 1. The results of structural magnetic resonance analysis showed that there were differences in volume of left hippocampus, perihippocampal gyrus and amygdala in the three groups. T test under two samples showed that the volume of left hippocampal, para-hippocampal gyrus and amygdala decreased in bipolar disorder manic phase and remission phase, but there was no significant difference in remission phase in manic phase. At the same time, no correlation was found between age, course of disease and frequency of onset in patients with mania and remission with the volume of left hippocampus, perihippocampal gyrus and amygdala. 2. The results of task-based magnetic resonance imaging. Compared with neutral interference factors, the variance of emotional interference factors showed that the brain regions with different activity were bilateral superior frontal gyrus, bilateral dorsal central prefrontal cortex, left dorsal prefrontal cortex, bilateral middle and lower orbital frontal cortex, right ventral anterior cingulate gyrus. Left dorsal cingulate gyrus, right posterior cingulate gyrus, bilateral superior middle temporal lobe, right putamen nucleus, bilateral cerebral island, bilateral hippocampus, left paracarpal gyrus, bilateral thalamus, bilateral superior parietal lobe, bilateral cuneiform lobe and prewedge lobe and bilateral middle and inferior occipital gyrus. T test of two samples under variance limitation showed that mania showed higher activity in the left dorsal prefrontal cortex and left superior parietal lobe than in the remission phase. The results of resting magnetic resonance variance showed that the difference of ReHo value among the three groups was as follows: right superior frontal gyrus, right precentral gyrus, right orbital frontal cortex, right dorsal anterior cingulate gyrus, bilateral superior temporal lobe, bilateral cerebral island. Bilateral superior parietal lobe and bilateral anterior cuneate lobe. The results of t-test of two samples under the limit of variance showed that the decrease of ReHo value in the manic phase compared with that in the remission phase was found in the brain regions with the increase of ReHo value in the bilateral precuneiform lobe and there were bilateral cerebral islands in the brain regions where the value of ReHo in the bilateral precuneial lobe increased. Conclusion: our study found the abnormality of the ventral-affective and dorsal-cognitive loops in PBD from several angles, which provides a new perspective for elucidating the pathophysiological basis of PBD. 17 figures, 19 tables, 382 references
【学位授予单位】：中南大学
【学位级别】：博士
【学位授予年份】：2013
【分类号】：R749.94;R445.2
【参考文献】
相关期刊论文 前2条
1 郭小娟;姚力;金真;;基于像素的形态测量学方法及其在脑图像处理中的应用[J];北京师范大学学报(自然科学版);2006年02期
2 曹枫林;苏林雁;程培霞;;情绪问卷中文版用于中学生的信度和效度研究[J];中国临床心理学杂志;2009年04期
，本文编号：2137938
本文链接：https://www.wllwen.com/yixuelunwen/eklw/2137938.html
最近更新
教材专著
