精神分裂症幻听的静息态脑网络研究

发布时间：2018-11-20 11:53

【摘要】：目的:使用独立成分分析法(ICA)研究精神分裂症幻听相关的脑网络特征性表现。方法:选取符合精神障碍诊断与统计手册第四修订版(DSM-IV-TR)精神分裂症的诊断标准患者,30例伴频繁幻听(AVH),24例不伴幻听(non-AVH),以及年龄、性别匹配的60例正常对照(HC)纳入统计分析。采用Hoffman幻听量表评估幻听的严重程度。采集所有受试者静息态的脑功能磁共振成像数据,利用ICA方法提取听觉网络、语言网络、突显网络、右额顶网络及默认网络,采用协方差分析比较三组受试者脑区活动在上述各网络内部的差异及网络间连接强度的差异,进一步评估AVH与non-AVH组间差异与幻听严重程度的关系。结果:与non-AVH组相比,AVH组听觉网络中的左侧颞上回和左侧中央后回的活动增强(P0.05,FDR校正),左侧颞上回脑区活动强度与幻听严重程度呈正相关(r=0.43,P0.05);AVH组突显网络中的右侧前扣带回的活动减弱(P0.05,FDR校正),且与幻听严重程度呈负相关(r=-0.48,P0.01)。网络间连接强度分析显示,与non-AVH组相比,AVH组语言网络-听觉网络连接强度减弱[(-0.29±0.21)vs.(-0.16±0.17),P0.05,未校正],突显网络-语言网络连接强度减弱[(-0.09±0.22)vs.(-0.06±0.18),P0.05,未校正],突显网络-听觉网络连接强度增强[(0.30±0.18)vs.(0.15±0.24),P0.05,未校正]。结论:本研究显示伴频繁幻听的精神分裂症患者听觉网络、语言网络及突显网络存在异常,提示精神分裂症患者幻听的产生可能和语言的产生、语音的感知及自我识别有关。
[Abstract]:Objective: to study the characteristic manifestations of auditory hallucination in schizophrenia by (ICA). Methods: 30 schizophrenic patients with frequent auditory hallucination (AVH),) without auditory hallucination (non-AVH) and age were selected, who met the criteria of schizophrenia in the fourth revised edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM-IV-TR). Sex-matched (HC) of 60 normal controls were included in the statistical analysis. The severity of auditory hallucination was evaluated by Hoffman auditory hallucination scale. The resting brain functional magnetic resonance imaging data of all subjects were collected, and auditory network, language network, right frontal apex network and default network were extracted by ICA method. Covariance analysis was used to compare the differences of brain area activity within the above networks and the internetwork connection intensity among the three groups, and to further evaluate the relationship between the differences between AVH and non-AVH groups and the severity of auditory hallucinations. Results: compared with non-AVH group, the activity of left superior temporal gyrus and left posterior central gyrus were increased in AVH group (P0.05). The intensity of activity in left superior temporal gyrus was positively correlated with the severity of auditory hallucination (r = 0.43). P0.05); The activity of right anterior cingulate gyrus in AVH group was decreased (P0.05 / FDR correction) and negatively correlated with the severity of auditory hallucination (r-0.48 ~ P0.01). The strength analysis of internetwork connection showed that compared with non-AVH group, the connection intensity of language network-auditory network in AVH group was decreased [(-0.29 卤0.21) vs. (-0.16 卤0.17), P 0.05, uncorrected]. The intensity of prominent network-language network connection was decreased [(-0.09 卤0.22) vs. (-0.06 卤0.18), P 0.05, uncorrected], and the intensity of salient network-auditory network connection was enhanced [(0.30 卤0.18) vs. (, 0.15 卤0.24)]. P0.05, not corrected]. Conclusion: this study shows that the auditory network, language network and salient network of schizophrenic patients with frequent auditory hallucinations are abnormal, suggesting that the occurrence of auditory hallucinations in schizophrenic patients may be related to the production of language, speech perception and self-recognition.
【作者单位】：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)国家精神心理疾病临床医学研究中心;
【基金】：国家科技支撑计划“基于临床医学研究协同网络的情感认知障碍综合诊疗关键技术研究”(2015BAI13B01) 科技部国家“973”计划项目子课题“弥漫性脑损害(精神分裂症)的脑网络研究”(2011CB707805)
【分类号】：R749.3

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