首发偏执型精神分裂症患者静息态脑功能fMRI研究

发布时间：2018-04-25 10:50

本文选题：精神分裂症 + 静息态　；参考：《南京医科大学》2013年硕士论文

【摘要】：目的：本研究利用功能磁共振成像(functional magnetic resonance imaging, fMRI)技术，旨在从局部一致性（regional homogeneity, ReHo）和低频振幅（amplitudeof low frequency fluctuation, ALFF）角度，探讨首次发病且未用药的偏执型精神分裂症(schizophrenia, SCH)患者静息状态下是否存在脑局部自发神经元活动异常以及异常脑区的定位。方法：采用美国精神疾病诊断与统计手册第4版（Diagnostic and Statistical Manualof Mental Disorders, Fourth edition, DSM-IV-TR）诊断入组精神分裂症患者；采用3.0T功能磁共振成像系统，对20例首发未用药的偏执型精神分裂症患者及同期入组的20名性别、年龄和受教育年相匹配的健康志愿者进行静息状态下全脑的fMRI检查；在进行磁共振扫描当天评估患者的阳性与阴性症状量表（positive andnegative symptom scale, PANSS）分。基于Matlab7.8软件平台，采用SPM8和REST软件对所获取的影像数据进行处理分析，计算出各受试者的ReHo值和ALFF值，采用独立样本t检验比较精神分裂症组相对于健康对照组ReHo值和ALFF值增高及降低的脑区，，当P0.005以及区域的体积不小于324mm3时，认为差异有统计学意义(Alphasim多重比较校正后P0.05)。结果：1，相比对照组，患者组静息态脑BOLD信号的ReHo值增高的脑区有右侧额上回和双侧楔前叶；ReHo值降低的脑区为左侧胼胝体。 2，相比对照组，患者组静息态脑BOLD信号的ALFF值增高的脑区有右侧额中回、右侧楔前叶、右侧小脑后叶；ALFF值降低的脑区为右侧边缘叶。结论：1，首发未用药偏执型精神分裂症患者存在静息状态下脑功能活动的fMRI信号异常。 2，偏执型精神分裂症患者右侧额上回、双侧楔前叶、左侧胼胝体ReHo异常可能与其神经自发活动的协调机制异常相关。 3，偏执型精神分裂症患者右侧额中回、楔前叶、小脑后叶、边缘叶ALFF异常提示其相应脑区的自发神经元活动水平异常。 4，ReHo和ALFF两种方法的结合，在一定程度上反映了相关脑区的功能活动异常，有助于更好地认识和理解精神分裂症的病理生理机制和脑网络功能活动特征。
[Abstract]:Objective: to investigate the regional homogeneity (ReHoe) and low frequency amplitude of low frequency imaging (ALFFF) in functional magnetic resonance imaging (fMRI). To investigate whether the spontaneous neuronal activity in the brain is abnormal and the location of the abnormal brain area in the resting state of the patients with first-onset and untreated paranoid schizophrenia (Sch). Methods: the Diagnostic and Statistical Manualof Mental Disorders, Fourth edition, DSM-IV-TR) were used to diagnose the patients with schizophrenia, and the 3.0T functional magnetic resonance imaging system was used to diagnose the patients with schizophrenia. FMRI examination of the whole brain was performed in 20 patients with first-episode untreated paranoid schizophrenia and 20 healthy volunteers who were matched in sex, age and years of education in the same period. Positive andnegative symptom scale (PANSS) was evaluated on the day of MRI. Based on the Matlab7.8 software platform, SPM8 and REST software are used to process and analyze the acquired image data, and the ReHo and ALFF values of each subject are calculated. An independent t-test was used to compare the brain regions of schizophrenic patients with higher and lower ReHo and ALFF values compared with those of healthy controls. When P0.005 and the volume of the regions were not less than 324mm3, the difference was statistically significant after the multiple comparison of Alphasim was corrected (P0.05). Results compared with the control group, the left corpus callosum was found in the right superior frontal gyrus and bilateral precuneial lobe where the ReHo value of BOLD signal was increased in the rest brain of the patient group compared with the control group. 2Compared with the control group, the right middle frontal gyrus, the right anterior cuneate lobe and the right posterior cerebellar lobe decreased the ALFF value of the resting brain in the right marginal lobe. Conclusion the fMRI signal of brain function was abnormal in patients with first episode nonmedication paranoid schizophrenia under resting state. 2. The abnormality of ReHo in the right superior frontal gyrus, bilateral anterior cuneate lobe and left corpus callosum in paranoid schizophrenic patients may be related to the abnormal coordination mechanism of nerve spontaneous activity. 3. The abnormal ALFF in the right middle frontal gyrus, anterior cuneiform lobe, posterior cerebellar lobe and marginal lobe of paranoid schizophrenia suggests the abnormal level of spontaneous neuron activity in the corresponding brain region. 4the combination of ReHo and ALFF may reflect the abnormal function of the related brain area to some extent, and help to better understand the pathophysiological mechanism and the functional characteristics of brain network in 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】：2013
【分类号】：R749.3;R445.2

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