精神分裂症患者吸烟的静息态功能磁共振研究

发布时间：2019-06-13 12:15

【摘要】：第一部分基于Re Ho探索精神分裂症患者吸烟的脑影像学机制目的:精神分裂症患者高吸烟率的原因尚不明确,静息态功能磁共振(rsfMRI)技术在神经精神疾病患者的脑机制研究中应用广泛,而局部一致性(ReHo)可以作为探索该现象的脑影像学机制良好工具。方法:采用静息态功能磁共振技术,比较吸烟精神分裂症患者组(SZ-S组)和不吸烟精神分裂症患者组(SZ-NS组),以及不吸烟精神分裂症患者和不吸烟正常对照组(HC-NS组)之间的局部一致性(ReHo)差异。结果:设p0.001,与不吸烟精神分裂症患者相比,吸烟精神分裂症患者在左内侧额回(MFG)的ReHo值下降,左侧小脑后叶(CPL)与左侧舌回(LG)的ReHo值升高,且吸烟精神分裂症患者左侧小脑后叶的ReHo值与患者每日吸烟支数显著正相关(r=0.635,p=0.027);与不吸烟正常对照组相比,不吸烟精神分裂症组患者的双侧内侧额回(MFG)、右侧颞叶(TL)、左侧楔叶(CUN)的ReHo值升高,右侧前扣带回(AnC)、双侧中央后回(PoCG)、双侧丘脑(THA)的ReHo值下降。结论:吸烟精神分裂症患者存在左侧小脑后叶,左内侧额回与左侧舌回的局部一致性异常可能是精神分裂症患者高吸烟率的脑影像学机制。第二部分基于ALFF探索精神分裂症患者吸烟的脑影像学机制目的:精神分裂症患者高吸烟率的原因尚不明确,静息态功能磁共振(rsf MRI)技术在神经精神疾病患者的脑机制研究中应用广泛,而低频振幅(ALFF)可以作为探索该现象的脑影像学机制良好指标。方法:本研究纳入符合精神障碍诊断与统计手册第4版(DSM-IV)诊断标准且年龄、性别及教育程度相匹配的吸烟精神分裂症患者、不吸烟精神分裂症患者及正常不吸烟对照者各21例,并对所有被试采集静息态功能磁共振影像(rsf MRI)。采用低频振幅的方法(ALFF)比较吸烟精神分裂症患者组(SZ-S)、不吸烟精神分裂症患者组(SZ-NS)以及正常不吸烟对照组(HC-NS)之间的的静息态功能磁共振图像的内部脑功能活动,然后对局部脑功能活动有异常的脑区分别与精神病性症状及尼古丁依赖严重程度进一步做相关分析。结果:前额叶皮质(PFC)、右侧尾状核(CAU)、右侧中央后回(Po CG)的ALFF与精神分裂症疾病和尼古丁依赖两个因素均相关。更重要的是与不吸烟精神分裂症患者相比较,吸烟精神分裂症患者可能逆转了疾病因素所致的上诉脑区的局部脑功能活动异常。此外,相对于不吸烟精神分裂症患者,吸烟精神分裂症患者的左侧纹状体(STR)和运动皮层(Mo C)的局部脑功能活动也有所改变。相关分析发现,右侧尾状核(CAU)的局部脑功能活动与精神分裂症症状严重程度呈负相关;右侧中央后回(Po CG)的局部脑功能活动与尼古丁依赖严重程度呈负相关。结论:吸烟可能有利于逆转了精神分裂症患者的右侧纹状体(STR)和前额叶皮层(PFC)的局部脑功能活动异常,这一结果支撑精神分裂症患者自我疗愈假说。另外,吸烟可能独立于疾病因素而影响到精神分裂症左侧纹状体(STR)和运动皮层(Mo C)的局部脑功能活动。这些结果提供了有助于理解精神分裂症患者高吸烟率的局部脑功能活动的脑影像学机制。
[Abstract]:The first part is to explore the brain imaging mechanism of smoking in the patients with schizophrenia based on Re Ho: the reason for the high smoking rate of the patients with schizophrenia is not clear, and the resting-state magnetic resonance (rsfMRI) technique is widely used in the research of the brain mechanism of patients with neuropsychiatric diseases. And the local consistency (ReHo) can be used as a good tool to explore the brain imaging mechanism of the phenomenon. Methods: The difference of the local consistency (ReHo) between the group (SZ-S group) and the non-smoking schizophrenia group (SZ-NS group) and the non-smoking healthy control group (HC-NS group) in the non-smoking schizophrenia group and the non-smoking healthy control group (HC-NS group) were compared by using the resting-state magnetic resonance technique. Results: There was a decrease in the ReHo value of the left medial frontal gyrus (MFG) and the increase in the ReHo value of the left cerebellar lobe (CPL) and the left tongue (LG), compared to those with non-smoking schizophrenia. The ReHo value of the posterior lobe of the left cerebellum of the patients with schizophrenia was significantly positively correlated with the daily smoking count of the patient (r = 0.635, p = 0.027), and the bilateral medial frontal gyrus (MFG) and right leaf (TL) of the non-smoking schizophrenia group compared to the non-smoking normal control group. The ReHo value of the left wedge leaf (CUN) increased, the right anterior cingulate (AnC), the bilateral central back (PoCG), and the bilateral thalamus (THA) 's ReHo value decreased. Conclusion: There is a brain imaging mechanism of high smoking rate in the patients with schizophrenia. The second part is based on ALFF to explore the brain imaging mechanism of smoking in the patients with schizophrenia: the reason for the high smoking rate in the patients with schizophrenia is not clear, and the resting-state magnetic resonance (rsf MRI) technique is widely used in the research of the brain mechanism of patients with neuropsychiatric diseases. And the low-frequency amplitude (ALFF) can be used as a good index to explore the brain imaging mechanism of the phenomenon. Methods: This study included 21 cases of smoking, non-smoking, non-smoking, and non-smoking, in accordance with the diagnostic criteria for the diagnosis and statistics of mental disorders, version 4 (DSM-IV), and the age, sex, and level of education. The resting-state magnetic resonance images (rsf MRI) were collected from all subjects. The low-frequency amplitude method (ALFF) was used to compare the internal brain function activity of the resting-state magnetic resonance image between the group of smokers (SZ-S), the non-smoking schizophrenia patient group (SZ-NS), and the normal non-smoking control group (HC-NS), And then the abnormal brain regions of the local brain function activity are further correlated with the psychotic symptoms and the severity of the nicotine dependence, respectively. Results: The ALFF of prefrontal cortex (PFC), right caudate nucleus (CAU) and right central back (Po CG) was related to the two factors of schizophrenia and nicotine dependence. It is more important to compare with non-smoking schizophrenia patients who may reverse the abnormal brain function activity in the area of appeal due to disease factors. In addition, the local brain function activity of the left striatal (STR) and the motor cortex (Mo C) of the smoking schizophrenia patient also changed with respect to the non-smoking schizophrenia patient. The correlation analysis found that the local brain function activity of the right caudate nucleus (CAU) was negatively correlated with the severity of the symptoms of schizophrenia, and the local brain function activity of the right central back-back (Po CG) was negatively correlated with the severity of the nicotine dependence. Conclusion: Smoking may be beneficial to reversing the abnormal brain function of the right striatal (STR) and prefrontal cortex (PFC) in the patients with schizophrenia, which supports the self-healing hypothesis of the patients with schizophrenia. In addition, smoking may affect the local brain function of the left striatal (STR) and the motor cortex (Mo C) of the schizophrenia independently of the disease factor. These results provide a brain imaging mechanism that helps to understand the local brain function activity of a high smoking rate in a patient with schizophrenia.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2018
【分类号】：R445.2;R749.3

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