CAJ | 학술논문

目的探讨精神分裂症患者在静息状态下脑活动局部一致性(ReHo)特点.方法对104例首次发病未服药精神分裂症患者(病例组)和104名健康对照者(对照组)进行静息态脑fMRI扫描,利用ReHo的方法分析数据并进行组间比较.采用偏相关分析功能活动异常脑区ReHo值与PANSS各因子间的相关性.结果与对照组相比,病例组ReHo降低的区域位于右侧前额叶眶额皮质(ReHo值:0.7±0.1,t=-3.502,P＜0.05)及背外侧皮质(ReHo值:1.0±0.1,t=-4.613,P＜0.05)、左侧前额叶眶额皮质(ReHo值:0.8±0.1,t=-4.778,P＜0.05)、后扣带回/楔前叶(ReHo值:1.2±0.1,t=-3.838,P＜0.05)、右侧顶下小叶(ReHo值:1.1±0.1,t=-4.275,P＜0.05)和右侧中央后回(ReHo值:0.9±0.1,t=-3.520,P＜0.05).ReHo增高的区域位于左侧小脑前叶(ReHo值:1.1±0.1,=4.081,P＜0.05)和后叶(ReHo值:1.0±0.1,t=3.660,P＜0.05)、右侧小脑后叶(ReHo值:0.8±0.1,t=3.359,P＜0.05)、以舌回为中心的左侧枕叶(ReHo值:0.7±0.1,t =3.986,P＜0.05)和右侧枕叶(ReHo值:1.1±0.1,t=3.362,P＜0.05),左侧颞上回/颞中回(ReHo值:1.1±0.1,=3.708,P ＜0.05)、左侧壳核/豆状核(ReHo值:1.0±0.1,t=4.457,P＜0.05).病例组右侧中央后回ReHo与阴性症状因子(r=-0.262,P＜0.01)、瓦解性症状因子(r=-0.219,P＜0.01)相关,右侧前额叶眶额皮质的ReHo与退缩性因子相关(r=-0.242,P ＜0.01).结论精神分裂症患者静息状态下的脑功能活动ReHo异常广泛分布,功能活动异常的脑区大多位于功能网络的节点脑区,可能与精神分裂症的病理机制有关.
목적 탐토정신분렬증환자재정식상태하뇌활동국부일치성(ReHo)특점.방법 대104례수차발병미복약정신분렬증환자(병례조)화104명건강대조자(대조조)진행정식태뇌fMRI소묘,이용ReHo적방법분석수거병진행조간비교.채용편상관분석공능활동이상뇌구ReHo치여PANSS각인자간적상관성.결과 여대조조상비,병례조ReHo강저적구역위우우측전액협광액피질(ReHo치:0.7±0.1,t=-3.502,P＜0.05)급배외측피질(ReHo치:1.0±0.1,t=-4.613,P＜0.05)、좌측전액협광액피질(ReHo치:0.8±0.1,t=-4.778,P＜0.05)、후구대회/설전협(ReHo치:1.2±0.1,t=-3.838,P＜0.05)、우측정하소협(ReHo치:1.1±0.1,t=-4.275,P＜0.05)화우측중앙후회(ReHo치:0.9±0.1,t=-3.520,P＜0.05).ReHo증고적구역위우좌측소뇌전협(ReHo치:1.1±0.1,=4.081,P＜0.05)화후협(ReHo치:1.0±0.1,t=3.660,P＜0.05)、우측소뇌후협(ReHo치:0.8±0.1,t=3.359,P＜0.05)、이설회위중심적좌측침협(ReHo치:0.7±0.1,t =3.986,P＜0.05)화우측침협(ReHo치:1.1±0.1,t=3.362,P＜0.05),좌측섭상회/섭중회(ReHo치:1.1±0.1,=3.708,P ＜0.05)、좌측각핵/두상핵(ReHo치:1.0±0.1,t=4.457,P＜0.05).병례조우측중앙후회ReHo여음성증상인자(r=-0.262,P＜0.01)、와해성증상인자(r=-0.219,P＜0.01)상관,우측전액협광액피질적ReHo여퇴축성인자상관(r=-0.242,P ＜0.01).결론 정신분렬증환자정식상태하적뇌공능활동ReHo이상엄범분포,공능활동이상적뇌구대다위우공능망락적절점뇌구,가능여정신분렬증적병리궤제유관.
Objective To explore the regional homogeneity (ReHo) of resting state brain activity in schizophrenia by using functional magnetic resonance imaging (fMRI).Methods One hundred and four first-episode treatment-naive schizophrenia (FES) patients,and 104 age/gender/education-matched healthy controls were examined by fMRI scans.ReHo of the resting-state brain activity was compared between the two groups.Relationships between abnormal ReHo of brain activity and clinical symptoms in patients were evaluated by partial correlation analysis.Results Compared with controls,FES patients showed significantly decreased regional homogeneity in right orbitofrontal cortex (ReHo:0.7 ± 0.1,t =-3.502,P ＜ 0.05),right dorsolateral prefrontal cortex (ReHo:1.0 ± 0.1,t =-4.613,P ＜ 0.05),left orbitofrontal cortex (ReHo:0.8 ± 0.1,t =-4.778,P ＜ 0.05),posterior cingulate cortex and precuneus (ReHo:1.2 ± 0.1,t =-3.838,P ＜ 0.05),the right lateral parietal cortex (ReHo:1.1 ± 0.1,t =-4.275,P ＜ 0.05) and postcentral gyrus (ReHo:0.9 ± 0.1,t =-3.520,P ＜ 0.05) ; the FES patients also showed increased ReHo in left anterior (ReHo:1.1 ±0.1,t =4.081,P ＜0.05) and posterior (ReHo:1.0 ±0.1,t =3.660,P ＜ 0.05) cerebellar lobe,right posterior cerebellar lobe (ReHo:0.8 ± 0.1,t =3.359,P ＜0.05),left (ReHo:0.7 ± 0.1,t =3.986,P ＜ 0.05) and right (ReHo:1.1 ± 0.1,t =3.362,P ＜ 0.05) occipital lobe,left superior and middle temporal gyrus (ReHo:1.1 ± 0.1,t =3.708,P ＜ 0.05),left putamen/lentiform nucleus (ReHo:1.0 ± 0.1,t =4.457,P ＜ 0.05).In patients,decreased ReHo in postcentral gyrus was correlated with negative symptoms (r =-0.262,P ＜ 0.01) and disorganization symptoms (r =-0.219,P ＜ 0.01),decreased ReHo in right orbitofrontal cortex was correlated with withdrawal symptoms (r =-0.242,P ＜ 0.01) in schizophrenia.Conclusions Our results indicate that abnormal ReHo of resting-state brain activity may be widely distributed in schizophrenia.The brain regions described above may be involve in the psychopathology and pathophysiology of schizophrenia.