伴发迟发性运动障碍精神分裂症患者大脑皮质形态学磁共振成像研究

发布时间：2018-02-16 23:45

本文关键词： 运动障碍药源性磁共振成像皮质形态精神分裂症　出处：《中国心理卫生杂志》2017年07期 　论文类型：期刊论文

【摘要】：目的:分析伴发迟发性运动障碍(TD)精神分裂症患者大脑皮质形态学特征及其与异常不自主运动严重程度间的关联,探讨TD发生可能的病理机制。方法:研究纳入伴发TD精神分裂症患者(TD组)32例、不伴发TD精神分裂症患者(非TD组)31例及健康对照(对照组)21例,TD和非TD组合并为精神分裂症组。分别采用阳性和阴性症状量表(PANSS)、异常不自主运动量表(AIMS)评估患者的精神病理和异常不自主运动症状;用磁共振成像技术采集头颅磁共振成像数据,应用Freesurfer软件计算大脑皮质体积、厚度、表面积及皮质下结构体积,比较3组间皮质形态学差异。结果:精神分裂症组右伏隔核、双海马、左额上回、左中央前上沟皮质体积以及左中央前上沟表面积比对照组小;TD组较非TD组右伏隔核体积小,左中央前上沟皮质体积、表面积大(均P0.05);以氯丙嗪当量和PANSS阴性症状分为协变量进行协方差分析,TD组左中央前上沟皮质体积、表面积仍较非TD组大[(2.03±0.07)×10~3mm~3 vs.(1.68±0.07)×10~3 mm~3,(1.01±0.03)×10~3 mm~2 vs.(0.84±0.03)×10~3 mm~2;均P0.05]。相关分析结果显示,精神分裂症组右额下回皮质厚度与PANSS阳性症状分、一般病理分负相关,与PANSS总分正相关;左枕颞侧沟皮质体积与PANSS一般病理分、PANSS总分负相关;右额下回皮质体积与PANSS阳性症状分正相关;右顶内沟顶横沟皮质体积与PANSS阳性症状分正相关。TD组AIMS总分与左中央前上沟皮质体积正相关(r=0.46,P0.01)。结论:TD患者左中央前上沟皮质体积、表面积增加,且与TD症状严重程度有关;左中央前上沟在TD的发病机制中可能起运动补偿作用。
[Abstract]:Objective: to analyze the morphological features of cerebral cortex and its relationship with the severity of abnormal involuntary motor movement in schizophrenic patients with delayed dyskinesia. Methods: 32 patients with TD schizophrenia were enrolled in this study. Patients without TD schizophrenia (31 cases in non-TD group and 31 cases in healthy control group) were assessed with positive and negative symptom scale (PANSS) and abnormal involuntary exercise scale (AIMS) respectively. Psychopathology and abnormal involuntary motor symptoms; The volume, thickness, surface area and subcortical structure volume of cerebral cortex were calculated by Freesurfer software, and the morphological differences of cortex were compared among the three groups. Results: right accumbent septum nucleus in schizophrenia group. The volume of bilateral hippocampus, left superior frontal gyrus, left precentral superior sulcus cortex and surface area of left precentral superior sulcus were smaller in TD group than in non-TD group, and the volume of left precentral superior sulcus cortex in TD group was smaller than that in non-TD group. The surface area of TD group was larger than that of non-TD group (2.03 卤0.07) 脳 10 ~ 3mm ~ (3 vs.(1.68 卤0.07) 脳 10 ~ (3) vs.(1.68 卤0.07) 脳 10 ~ (3) 卤0.03 mm ~ (-1) 脳 10 ~ (3) mm ~ (-3) 脳 10 ~ (3) mm ~ (-3) 脳 10 ~ (3) mm ~ (-2) 脳 10 ~ (3) mm ~ (-2) 脳 10 ~ (-3) mm ~ (-2) 脳 10 ~ (-3) mm ~ (-2). The results of correlation analysis showed that the surface area of TD group was still larger than that of non-TD group [2.03 卤0.07) 脳 10 ~ 3 mm ~ 3 卤0.07]. In the schizophrenia group, the thickness of the right inferior frontal cortex was negatively correlated with the positive symptoms of PANSS, the general pathological score was negatively correlated with the total score of PANSS, and the cortical volume of the left occipito-temporal sulcus was negatively correlated with the total score of PANSS. The cortical volume of right subfrontal gyrus was positively correlated with the positive score of PANSS, the cortical volume of right medial sulcus was positively correlated with the score of PANSS positive symptoms. The total score of AIMS in TD group was positively correlated with the volume of left precentral superior sulcus cortex. The surface area is increased and is related to the severity of TD symptoms, and the left precentral sulcus may play a role in motor compensation in the pathogenesis of TD.
【作者单位】：北京回龙观医院北京大学回龙观临床医学院;北京大学第六医院北京大学精神卫生研究所卫生部精神卫生学重点实验室(北京大学);
【基金】：北京市自然科学基金重点项目(7151005)
【分类号】：R749.3

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