首发精神分裂症患者脑局部一致性静息态MRI研究

摘要

目的:采用脑静息态功能磁共振成像(fMRI)局部一致性(ReHo)方法探讨首发精神分裂症患者脑区自发性活动特征,评价内在脑功能状态与外在表现的关联.方法:对符合美国精神障碍诊断与统计手册第四版(DSM-IV)诊断标准的60例首发精神分裂症患者(病例组)和32例健康受试者(对照组)在静息状态下采集fMRI数据,并计算ReHo值,比较两组间ReHo差异,并分析这种变化与阳性阴性症状量表(PANSS)临床症状评分的相关性.结果:与对照组相比,首发精神分裂症患者右背外侧前额叶、左内侧前额叶、双侧壳核ReHo值增高;双侧枕中回、舌回、梭状回ReHo值减低,差异有统计学意义(Alphaism校正后P＜0.05且体素范围k＞10).左内侧前额叶更高的ReHo值与PANSS妄想评分呈正相关(P＜0.05).结论:首发精神分裂症患者静息态时可能存在广泛的自发神经元活动异常,左内侧前额叶更高的激活与妄想相关.%Objective:To explore the characteristics of spontaneous activity of brain regions in first-episode schizophrenic patients by means of resting state functional magnetic resonance imaging (rsfMRI) with regional homogeneity (ReHo),and to further evaluate the correlation between intrinsic brain function and external manifestation of schizophrenia.Methods:Sixty first-episode schizophrenic patients (case group) and thirty-two healthy subjects (control group) were included in this study.The fMRI data were collected at resting state and the ReHo values were calculated.The difference of ReHo values between two groups was compared,and the correlation between the differences and the clinical symptom scores of the positive negative syndrome scale (PANSS) were analyzed.Results:Compared with control group,ReHo values increased markedly in first-episode schizophrenic patients in the right dorsolateral prefrontal cortex,left medial prefrontal cortex and bilateral putamens;while ReHo values significantly decreased in the areas of bilateral medial occipital,lingual,and fusiform gyri (P＜0.05,Alphaism correction,voxels k＞ 10).The higher ReHo value of the left medial prefrontal lobe was significantly associated with the PANSS delusional scores (P＜0.05).Conclusion:There may be a wide range of spontaneous neuronal activity abnormalities in the patients with first-episode schizophrenia in the resting state,and the higher activation of the left medial prefrontal lobe is associated with delusion.