CAJ | 학술논문

目的利用弥散张量成像(DTI)探讨未治疗的广泛性焦虑障碍(generalized anxietvdisorder,GAD)患者全脑的微观结构.方法对16例未治疗的GAD患者(患者组)和26例健康对照(对照组)进行DTI和结构核磁共振成像大脑扫描,使用基于体素的分析法比较2组脑微观结构的分数各向异性(FA),计算差异脑区FA平均值,并与病程、临床症状严重程度[汉密尔顿焦虑量表(HAMA)评分、宾尼法尼亚担心状态问卷(PSWQ)评分]进行Pearson相关分析.结果与对照组比较,患者组右侧杏仁核FA值增高(FDR纠正后P=0.009),前扣带尾部/中扣带回皮质FA值降低(FDR纠正后P=0.011)；患者组右侧杏仁核FA值与HAMA评分(r=0.584,P=0.017)和PSWQ评分(r =0.647,P=0.007)呈正性相关.结论 GAD患者大脑微观结构中以杏仁核为核心的恐惧条件反射神经环路受损,杏仁核受损程度可能是GAD患者的易感因素之一.
목적 이용미산장량성상(DTI)탐토미치료적엄범성초필장애(generalized anxietvdisorder,GAD)환자전뇌적미관결구.방법 대16례미치료적GAD환자(환자조)화26례건강대조(대조조)진행DTI화결구핵자공진성상대뇌소묘,사용기우체소적분석법비교2조뇌미관결구적분수각향이성(FA),계산차이뇌구FA평균치,병여병정、림상증상엄중정도[한밀이돈초필량표(HAMA)평분、빈니법니아담심상태문권(PSWQ)평분]진행Pearson상관분석.결과 여대조조비교,환자조우측행인핵FA치증고(FDR규정후P=0.009),전구대미부/중구대회피질FA치강저(FDR규정후P=0.011)；환자조우측행인핵FA치여HAMA평분(r=0.584,P=0.017)화PSWQ평분(r =0.647,P=0.007)정정성상관.결론 GAD환자대뇌미관결구중이행인핵위핵심적공구조건반사신경배로수손,행인핵수손정도가능시GAD환자적역감인소지일.
Objective To assess the white matter microstructure integrity of brain in patients with first-episode treatment-naive general anxiety disorders (GAD) using diffusion tensor imaging (DTI).To explore the possible pathological mechanism of brain function in GAD from neuroimaging field.Methods Sixteen patients with GAD and twenty-six age-and sex-matched healthy controls were enrolled.All subjects underwent diffusion tensor imaging and structural magnetic resonance imaging brain scanning,the fractional anisotropy (FA) in brain microstructure of the two groups were compared by voxel-based analysis,and the FA in these significant different areas of each subject were calculated.Associations between clinical ratings of symptom severity (i.e.,the Hamilton Anxiety Scale and the Penn State Worry Questionnaire) and FA were assessed.Results The patients demonstrated significantly higher FA in the right amygdala white matter and lower FA in the caudal ACC/midcingulate cortex white matter compared with the controls (P =0.009,P =0.011).Higher FA in the right amygdala was correlated with higher Hamilton Anxiety Scale scores (r =0.584,P =0.017) and higher Penn State Worry Questionnaire scores (r =0.647,P =0.007).Conclusions Higher FA in amygdala in GAD patients suggests that the connectivity among amygdala and some other brain areas maybe increase,which imply the activate of amygdala-based fear conditional reflex neural circuitry be abnormal.Amygdala extent of the damage may be one of predisposing factors to GAD.