首发精神分裂症患者静息态低频振幅fMRI研究

发布时间：2018-01-30 13:47

本文关键词： 首发精神分裂症静息态低频振幅默认网络　出处：《南京医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的近年来功能磁共振成像技术(functional magnetic resonance imaging,fMRI)研究精神分裂症,主要采用功能连接的数据分析方法,已有大量研究通过这个方法得出精神分裂症是一种功能连接异常的疾病。功能连接是从时间上相关脑区的活动异常来阐明精神分裂症患者的可能发病机制,不能直接说明某个脑区自发活动的情况。低频振幅方法能反映大脑静息态下局部脑区活动的异常。本研究通过对首发精神分裂症患者与健康对照进行比较,通过使用低频振幅(Amplitude of Low Frequency Fluctuation, ALFF)和低频振幅比率(Fractional Amplitude of Low Frequency Fluctuation, fALFF)的方法分析,并同时排除了病程和药物对静息态磁共振数据的影响,研究首发精神分裂症患者在静息态下局部脑区活动的改变情况。方法将符合美国《精神障碍诊断与统计手册第四版》(Diagnostic and Statistical Manua of Mental Disorders, Fourth edition, DSM-IV)中精神分裂症的诊断标准入组精神分裂症患者,本研究收集的精神分裂症患者还必须符合首次发病且未用药的标准。对27例首发精神分裂症患者(患者组)和22例性别、年龄及受教育程度与患者组相匹配的健康对照(健康对照组),使用3.0T功能磁共振,进行全脑静息态功能磁共振成像(resting state functional magnetic resonance imaging, Rs-fMRI)扫描,数据扫描的当天先由一名主治医师评估精神分裂症患者的阴性与阳性症状量表(positive and negative symptom scale, PANSS)分。对Rs-fMRI数据采用SPM8软件进行预处理,本研究中头动平移lmm和旋转移动1。的被试者将被删除。对于预处理后的数据采用Rest1.6软件进行静息态下各局部脑区ALFF和fALFF的差异分析。为比较患者组和健康对照组在静息态下全脑局部脑区的ALFF和fALFF的改变情况,将处理后的两组ALFF和fALFF图像分别进行双样本t检验。在体素水平时取单个体素P0.01,连续体素数18的脑区,再行蒙特卡罗模拟法Alphaism矫正,校正后当t2.36时,P0.05,这些异常的脑区就认为是差异有统计学意义的区域。结果 1.ALFF结果 1.1.与健康对照组相比,患者组ALFF显著增高的脑区是运动前区、辅助运动区和眶额回(P0.05, Alphaism矫正)。 1.2.与健康对照组相比,患者组ALFF显著降低的脑区是楔前叶、后扣带回、内侧前额叶和角回,差异均有统计学意义(P0.05, Alphaism矫正)。 2.fALFF结果 2.1.与健康对照组相比,患者fALFF显著增高的脑区是眶额回(P0.05,Alphaism矫正)。 2.2.与健康对照组相比,患者组fALFF显著降低的脑区是楔前叶、后扣带回、左背外侧前额叶和左角回,差异均有统计学意义(P0.05, Alphaism矫正)。结论 1.首发精神分裂症患者在静息态下存在运动前区、辅助运动区、眶额回、楔前叶、后扣带回、内侧前额叶、角回和左背外侧前额叶的局部脑区异常。 2.本研究同时使用ALFF和fALFF方法对同一批数据进行分析,使用这两种方法分析都发现首发精神分裂症患者存在眶额回、楔前叶、后扣带回和角回的异常,得出的结果可靠性高。 3.这些异常的脑区涉及默认网络及任务正激活网络。 4.这些异常的脑区可能有助于解释精神分裂症的病理机制。
[Abstract]:objective
In recent years, functional magnetic resonance imaging (functional magnetic resonance imaging, fMRI) of schizophrenia research, mainly uses the data of functional connectivity analysis method, a large number of studies have been obtained by this method of schizophrenia is a disorder of a connecting function. Function is connected from the time of brain regions related to abnormal events to clarify the spirit the possible pathogenesis in patients with schizophrenia, not directly explain the spontaneous activity in a brain region. The low-frequency amplitude method can reflect the abnormal brain resting state brain activity. This study was conducted to compare patients with first-episode schizophrenia and healthy controls by using low frequency amplitude (Amplitude of Low Frequency Fluctuation, ALFF) low frequency and amplitude ratio (Fractional Amplitude of Low Frequency Fluctuation, fALFF) method of analysis, and also ruled out the course of disease and drugs on The influence of resting state magnetic resonance data to study the changes in the local brain activity in the resting state of the first schizophrenic patients.
The United States will comply with the "diagnostic and Statistical Manual of mental disorders Fourth Edition (Diagnostic and Statistical Manua > of Mental Disorders, Fourth edition, DSM-IV) in diagnostic criteria for schizophrenia in patients with schizophrenia, this study collected the patients with schizophrenia must also comply with the first onset and no drug standard. In 27 cases patients with first-episode schizophrenia (patient group) and 22 cases of sex, age and education level and patients matched healthy controls (healthy control group), the use of 3.0T functional magnetic resonance imaging, whole brain resting state functional magnetic resonance imaging (resting state functional magnetic resonance imaging, Rs-fMRI) scanning, the first one physicians assess mental data scan in patients with positive and negative schizophrenia symptoms scale (positive and negative symptom scale, PANSS). The Rs-fMRI data with SPM8 software The pretreatment, this study head LMM translation and rotation movement of 1. subjects will be deleted. The preprocessed data analysis of difference between ALFF and fALFF of the brain of resting state by Rest1.6 software. In order to change the situation between patients and healthy controls in the resting state brain local the brain region of ALFF and fALFF, two groups of ALFF and fALFF after image processing were two sample t test. Take single voxel P0.01 at the voxel level, the 18 prime continuum brain regions, and the Monte Carlo simulation method Alphaism correction after correction, when t2.36, P0.05, the abnormal brain area is that there was a statistically significant difference in area.
Result
1.ALFF results
Compared with the healthy control group, the brain area of ALFF in the patient group was significantly higher than that in the premotor area and the auxiliary motor area and the orbital frontal gyrus (P0.05, Alphaism correction) in the patient group.
Compared with the healthy control group, the ALFF area of the 1.2. group was significantly lower than that of the healthy control group, the difference was statistically significant (P0.05, Alphaism correction).
2.fALFF results
Compared with the health control group, the significantly higher brain area of the patients with fALFF was the orbital frontal gyrus (P0.05, Alphaism correction).
Compared with the healthy control group, the fALFF area of the 2.2. group was significantly lower than that of the healthy control group, the difference was statistically significant (P0.05, Alphaism correction).
conclusion
1., in the resting state, there were abnormalities in the premotor area, the supplementary motor area, the orbital frontal gyrus, the anterior cingulate lobe, the posterior cingulate cortex, the medial prefrontal cortex, the angular gyrus and the left lateral prefrontal cortex in the first episode schizophrenic patients.
2., this study used ALFF and fALFF to analyze the same data. Using these two methods, we found that there were abnormalities in orbital frontal gyrus, wedge anterior, posterior cingulate gyrus and angular gyrus in first episode schizophrenics, and the results were reliable.
3. these abnormal brain areas involve the default network and the task is activating the network.
4. these abnormal brain regions may help to explain the pathological mechanism of schizophrenia.

【学位授予单位】：南京医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R749.3

【共引文献】