首发精神分裂症脑白质弥散张量成像研究
发布时间：2018-09-14 08:06
【摘要】：背景：白质完整性是保持脑功能连接正常的结构基础。以往研究已表明精神分裂症存在脑区异常,而越来越多的证据支持精神分裂症更可能是一种脑区连接异常疾病。因此精神分裂症可能存在一定程度的白质纤维结构异常,但目前国内外相关研究尚存在较多争议。 目的：(1)运用弥散张量成像技术(DTI)和基于纤维束的空间统计方法(TBSS)探讨首发未服药精神分裂症患者的脑白质纤维束结构的异常；(2)探讨首发未服药精神分裂症患者的白质纤维束异常与其精神病症状和认知功能的关系；(3)呈现首发精神分裂症患者与健康被试存在差异区域的立体纤维重建。 方法：根据严格标准纳入27例精神分裂症患者和20例年龄、性别相匹配的健康被试,使用阳性与阴性量表(PANSS)评估患者精神病症状,使用连线测验(TMT)、Stroop测验、威斯康星卡片分类测验(WCST)、停止信号任务(SST)和动态记忆任务等五种神经心理学测验评定患者和健康人的认知功能。对两组被试进行DTI扫描,使用FSL5.0软件进行TBSS分析,比较两组被试脑白质纤维的部分各向异性(FA)。再提取两组被试FA有显著差异的白质纤维束的FA值,使用SPSS18.0计算FA与PANSS与神经心理测验得分的相关关系。最后,使用Diffusion Toolkit和Trackvis重建两组被试差异区的白质纤维。 结果：(1)首发未服药精神分裂症患者的双侧胼胝体体部、左侧胼胝体膝部、右侧辐射冠前区、双侧辐射冠上部、右侧内囊前肢、左侧扣带FA值显著小于正常对照组(p0.05)；(2)除停止信号任务之外,首发未服药精神分裂症患者在连线测验、Stroop测验、威斯康星卡片分类测验、动态记忆任务中的得分与正常对照组有显著差异(p0.05)；(3)首发未服药精神分裂症患者的PANSS总分与其全脑平均FA呈显著负相关(r=-0.39,p=0.04),PANSS阴性症状分与辐射冠上部FA呈显著正相关(r=0.44,p=0.02),停止信号任务的反应信号反应时与胼胝体体部FA (r=-0.48, p=0.02)、右侧内囊前肢FA呈显著负相关(r=-0.42,p=0.04),Stroop测验颜色-字矛盾条件下的读字数与辐射冠上部FA呈显著正相关(r=0.43,p=0.03),威斯康星卡片分类测验的正确应答数与左侧扣带束FA呈显著正相关(r=0.54,p=0.01)。(4)首发精神分裂症患者的胼胝体体部平均纤维长度显著短于正常组(p0.05)。 结论：(1)首发未服药精神分裂症患者的脑白质受到损伤,损伤区域主要包括：双侧胼胝体体部、左侧胼胝体膝部、右侧辐射冠前区、双侧辐射冠上部、左侧扣带、右侧内囊前肢；(2)首发未服药精神分裂症患者的脑白质损伤与其疾病症状和认知功能缺陷存在显著相关关系；(3)精神分裂症患者的脑白质损伤在疾病早期已经出现,可能是神经纤维脱髓鞘的结果。
[Abstract]:Background: White matter integrity is the structural basis for maintaining normal brain functional connections. Previous studies have shown that schizophrenia has abnormal brain regions, and more evidence supports that schizophrenia is more likely to be an abnormal brain area connection disease. Therefore, there may be some abnormalities in the structure of white matter fibers in schizophrenia, but there is still much controversy at home and abroad. Objective: (1) to investigate the abnormal structure of white matter fiber bundle in patients with first-episode schizophrenia by using diffusion-Zhang Liang imaging technique (DTI) and spatial statistical method based on fiber bundle (TBSS). (2) to explore the relationship between abnormal white matter fiber bundle and mental symptoms and cognitive function in first-episode schizophrenic patients, and (3) to explore the reconstruction of stereoscopic fibers in patients with first-episode schizophrenia and healthy subjects. Methods: according to the strict criteria, 27 schizophrenic patients and 20 healthy subjects of age and sex were included. The positive and negative (PANSS) were used to evaluate the psychiatric symptoms of the patients, and the (TMT) Stroop test was used to test the psychosis symptoms. Wisconsin card sorting test (WCST), stop signal task (SST) and dynamic memory task five neuropsychological tests were used to assess the cognitive function of patients and healthy persons. Two groups of subjects were scanned by DTI and TBSS was analyzed by FSL5.0 software. The partial anisotropic (FA). Of white matter fibers was compared between the two groups. The FA value of white matter fiber bundle with significant difference in FA was extracted from the two groups. The correlation between FA and PANSS and the score of neuropsychological test was calculated by SPSS18.0. Finally, Diffusion Toolkit and Trackvis were used to reconstruct the white matter fibers in the difference area between the two groups. Results: (1) the FA values of bilateral corpus callosum, left genu of corpus callosum, right anterior coronal area, upper part of bilateral radiative crown, anterior limb of right internal capsule and left cingulate zone in patients with first-episode schizophrenia were significantly lower than those in control group (p0.05). (2) in addition to the task of stopping signal, the scores of first-episode patients without medication in Stroop test, Wisconsin card sorting test and dynamic memory task were significantly different from those in normal control group (p0.05). (3) there was a significant negative correlation between the total score of PANSS and the average FA of the whole brain in patients with first-episode schizophrenia (r-0.39, p0.04). There was a significant positive correlation between the score of negative symptoms of PANSS and the FA of the upper part of the radiative crown (r = 0.44, p0. 02). The response signal response to stop the signal task was associated with the corpus callosum. FA (r-0.48, p0. 02) and FA of the right anterior limb of the internal capsule were negatively correlated (r-0. 42 p0. 04). There was a significant positive correlation between the number of words read under the condition of color-word contradiction in the Stroop test and the FA in the upper part of the radiometric crown (r 0. 43 p0. 03). The correct response number of Wisconsin card sorting test was positively correlated with the FA of the left cingulate band. The average fiber length of corpus callosum in first-episode schizophrenia patients was significantly shorter than that in normal controls (P 0.05). Conclusion: (1) the white matter was injured in patients with first-episode non-medication schizophrenia. The main areas of injury included bilateral corpus callosum, left genu of corpus callosum, right anterior coronal area, upper part of bilateral radiative corona and left cingulate band. The anterior limb of the right internal capsule; (2) the white matter injury in patients with first-episode non-medication schizophrenia was significantly correlated with the symptoms of the disease and cognitive impairment; (3) the white matter damage of the schizophrenic patients had already appeared in the early stage of the disease. This may be the result of demyelination of nerve fibers.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R749.3
本文编号：2242077
[Abstract]:Background: White matter integrity is the structural basis for maintaining normal brain functional connections. Previous studies have shown that schizophrenia has abnormal brain regions, and more evidence supports that schizophrenia is more likely to be an abnormal brain area connection disease. Therefore, there may be some abnormalities in the structure of white matter fibers in schizophrenia, but there is still much controversy at home and abroad. Objective: (1) to investigate the abnormal structure of white matter fiber bundle in patients with first-episode schizophrenia by using diffusion-Zhang Liang imaging technique (DTI) and spatial statistical method based on fiber bundle (TBSS). (2) to explore the relationship between abnormal white matter fiber bundle and mental symptoms and cognitive function in first-episode schizophrenic patients, and (3) to explore the reconstruction of stereoscopic fibers in patients with first-episode schizophrenia and healthy subjects. Methods: according to the strict criteria, 27 schizophrenic patients and 20 healthy subjects of age and sex were included. The positive and negative (PANSS) were used to evaluate the psychiatric symptoms of the patients, and the (TMT) Stroop test was used to test the psychosis symptoms. Wisconsin card sorting test (WCST), stop signal task (SST) and dynamic memory task five neuropsychological tests were used to assess the cognitive function of patients and healthy persons. Two groups of subjects were scanned by DTI and TBSS was analyzed by FSL5.0 software. The partial anisotropic (FA). Of white matter fibers was compared between the two groups. The FA value of white matter fiber bundle with significant difference in FA was extracted from the two groups. The correlation between FA and PANSS and the score of neuropsychological test was calculated by SPSS18.0. Finally, Diffusion Toolkit and Trackvis were used to reconstruct the white matter fibers in the difference area between the two groups. Results: (1) the FA values of bilateral corpus callosum, left genu of corpus callosum, right anterior coronal area, upper part of bilateral radiative crown, anterior limb of right internal capsule and left cingulate zone in patients with first-episode schizophrenia were significantly lower than those in control group (p0.05). (2) in addition to the task of stopping signal, the scores of first-episode patients without medication in Stroop test, Wisconsin card sorting test and dynamic memory task were significantly different from those in normal control group (p0.05). (3) there was a significant negative correlation between the total score of PANSS and the average FA of the whole brain in patients with first-episode schizophrenia (r-0.39, p0.04). There was a significant positive correlation between the score of negative symptoms of PANSS and the FA of the upper part of the radiative crown (r = 0.44, p0. 02). The response signal response to stop the signal task was associated with the corpus callosum. FA (r-0.48, p0. 02) and FA of the right anterior limb of the internal capsule were negatively correlated (r-0. 42 p0. 04). There was a significant positive correlation between the number of words read under the condition of color-word contradiction in the Stroop test and the FA in the upper part of the radiometric crown (r 0. 43 p0. 03). The correct response number of Wisconsin card sorting test was positively correlated with the FA of the left cingulate band. The average fiber length of corpus callosum in first-episode schizophrenia patients was significantly shorter than that in normal controls (P 0.05). Conclusion: (1) the white matter was injured in patients with first-episode non-medication schizophrenia. The main areas of injury included bilateral corpus callosum, left genu of corpus callosum, right anterior coronal area, upper part of bilateral radiative corona and left cingulate band. The anterior limb of the right internal capsule; (2) the white matter injury in patients with first-episode non-medication schizophrenia was significantly correlated with the symptoms of the disease and cognitive impairment; (3) the white matter damage of the schizophrenic patients had already appeared in the early stage of the disease. This may be the result of demyelination of nerve fibers.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R749.3
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相关期刊论文 前2条
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