CAJ | 학술논문

目的探讨缺陷型精神分裂症患者后扣带回相关的静息脑功能连接网络与对照的差异.方法选取年龄、教育程度相匹配的缺陷型精神分裂症患者(缺陷组)、非缺陷型精神分裂症患者(非缺陷组)、健康志愿者(对照组)各30例男性,进行静息态fMRI扫描,以后扣带回为种子点,与全脑其他区域进行基于体素相关分析,比较3组间后扣带回功能连接网络变化.结果排除头动因素后,缺陷组27例、非缺陷组26例、对照组25名纳入分析:(1)缺陷组阴性症状量表总分(26.7±2.4)分、缺陷型精神分裂症诊断量表阴性症状分(11.2±2.7)分,均较非缺陷组高[分别为(14.3±1.2)分,(4.1±2.6)分],差异有统计学意义(t值分别为23.667、9.812,P＜0.01).(2)3组间后扣带回功能连接网络差异有统计学意义的脑区集中于左、右侧额中回,左、右侧额上回,左侧额下回,左、右侧小脑,左、右侧小脑后叶,左侧颞下回,右侧颞中回,左侧尾状核,左、右侧边缘叶(海马旁回),左侧楔叶,左、右侧楔前叶.(3)缺陷组与对照组比较,后扣带回功能连接减弱的脑区有:左、右侧额中回(背外侧),左、右侧小脑,左侧边缘叶,左侧丘脑,右侧顶叶,左侧前扣带回.增强的脑区有:左侧楔前叶,左侧顶上小叶.(4)缺陷组与非缺陷组比较,后扣带回功能连接减弱的脑区有:右侧顶叶,左侧楔前叶.增强的脑区:左、右侧额下回,左侧额上回(背侧),左侧颞叶.结论缺陷型精神分裂症可能存在特定的后扣带回功能连接网络模式,存在左侧边缘叶、双侧额中回等脑区连接减弱,提示缺陷型精神分裂症可能为一种独立的疾病亚型.
목적 탐토결함형정신분렬증환자후구대회상관적정식뇌공능련접망락여대조적차이.방법 선취년령、교육정도상필배적결함형정신분렬증환자(결함조)、비결함형정신분렬증환자(비결함조)、건강지원자(대조조)각30례남성,진행정식태fMRI소묘,이후구대회위충자점,여전뇌기타구역진행기우체소상관분석,비교3조간후구대회공능련접망락변화.결과 배제두동인소후,결함조27례、비결함조26례、대조조25명납입분석:(1)결함조음성증상량표총분(26.7±2.4)분、결함형정신분렬증진단량표음성증상분(11.2±2.7)분,균교비결함조고[분별위(14.3±1.2)분,(4.1±2.6)분],차이유통계학의의(t치분별위23.667、9.812,P＜0.01).(2)3조간후구대회공능련접망락차이유통계학의의적뇌구집중우좌、우측액중회,좌、우측액상회,좌측액하회,좌、우측소뇌,좌、우측소뇌후협,좌측섭하회,우측섭중회,좌측미상핵,좌、우측변연협(해마방회),좌측설협,좌、우측설전협.(3)결함조여대조조비교,후구대회공능련접감약적뇌구유:좌、우측액중회(배외측),좌、우측소뇌,좌측변연협,좌측구뇌,우측정협,좌측전구대회.증강적뇌구유:좌측설전협,좌측정상소협.(4)결함조여비결함조비교,후구대회공능련접감약적뇌구유:우측정협,좌측설전협.증강적뇌구:좌、우측액하회,좌측액상회(배측),좌측섭협.결론 결함형정신분렬증가능존재특정적후구대회공능련접망락모식,존재좌측변연협、쌍측액중회등뇌구련접감약,제시결함형정신분렬증가능위일충독립적질병아형.
Objective To explore the discrepancies of the network of resting brain functional connectivity related to posterior cingulated cortex (PCC) between deficit schizophrenia patients and normal control.Methods Thirty male patients of deficit schizophrenia,nondeficit schizophrenia and 30 healthy controls were enrolled,and the age,education level and sex were matched between three groups.Resting state fMRI was performed on all the subjects.Correlation analysis between PCC and all the other voxels in the brain was performed with a voxel-wise manner and the changes of network of PCC functional connectivity between three groups were compared.Results There were valid data of 27 patients in deficit group,26 patients in nondeficit group,25 persons in control group.The scores of SANS (26.7 ± 2.4) and SDS (11.2±2.7) in deficit group were higher than that in nondeficit group (14.3 ± 1.2,4.1 ±2.6;t =23.667,9.812,P ＜0.01).(2)In three groups,areas showing significant functional connectivity to PCC included left and right middle frontal gyrus,left and right superior frontal gyrus,left inferior frontal gyrus,left and right cerebellum,left and right posterior lobe of cerebellum,left inferior temporal gyrus,right middle temporal gyrus,left caudate nucleus,left and right limbic lobe (parahippocampal gyrus),left cuneate lobe,left and right precuneus.(3)The weaker functional connectivity to PCC in deficit schizophrenia patients than normal control included areas of left and right middle frontal gyrus,left and right cerebellum,left limbic lobe,left thalamus,right parietal lobe,the left anterior cingulated cortex,while stronger connectivity in areas of left precuneus and left parietal lobule.(4)The weaker functional connectivity to PCC in deficit schizophrenia patients than non-deficit schizophrenia patients included areas of right parietal lobule and left precuneus,while stronger connectivity were in areas of left and right inferior frontal gyrus,left superior frontal gyrus,left temporal lobe.Conclusions Deficit schizophrenia may exist specific PCC functional connectivity network mode,and the weakened brain regions connection be in left limbic lobe,left and right middle frontal gyrus and so on.It suggests that deficit schizophrenia may be an independent disease subtype.