CAJ | 학술논문

目的运用扩散张量成像(DTI)技术检测创伤后应激障碍(PTSD)患者脑结构完整性的变化及其与临床症状间的关系.资料与方法10例交通伤后应激障碍患者和10例无应激障碍的交通事故亲历者进行 DTI 扫描,应用基于体素的分析方法比较两组受试者的部分各向异性分数(FA)值和平均扩散系数(MD),并分析有差异脑区的 FA 值和 MD 值与创伤后应激障碍自评量表(PCL-C)评分之间的相关性.结果与无应激障碍者比较,PTSD 患者双侧额中回、右侧额上回及左侧壳核 FA 值显著降低(P<0.01),双侧额中回、前扣带回及左侧杏仁核、脑岛、苍白球的 MD 值显著增高(P<0.01). PTSD 患者右侧额中回 FA 值与 PCL-C 评分无明显相关性(r=-0.628, P>0.05),但呈负相关趋势;右侧额中回及左侧杏仁核 MD 值与 PCL-C 评分无明显相关性(r =0.630, P>0.05; r=0.632, P >0.05),但呈正相关趋势.结论 PTSD 患者大脑结构完整性下降,杏仁核和额中回脑区改变可能是其情感和记忆功能障碍的结构基础.
목적운용확산장량성상(DTI)기술검측창상후응격장애(PTSD)환자뇌결구완정성적변화급기여림상증상간적관계.자료여방법10례교통상후응격장애환자화10례무응격장애적교통사고친력자진행 DTI 소묘,응용기우체소적분석방법비교량조수시자적부분각향이성분수(FA)치화평균확산계수(MD),병분석유차이뇌구적 FA 치화 MD 치여창상후응격장애자평량표(PCL-C)평분지간적상관성.결과여무응격장애자비교,PTSD 환자쌍측액중회、우측액상회급좌측각핵 FA 치현저강저(P<0.01),쌍측액중회、전구대회급좌측행인핵、뇌도、창백구적 MD 치현저증고(P<0.01). PTSD 환자우측액중회 FA 치여 PCL-C 평분무명현상관성(r=-0.628, P>0.05),단정부상관추세;우측액중회급좌측행인핵 MD 치여 PCL-C 평분무명현상관성(r =0.630, P>0.05; r=0.632, P >0.05),단정정상관추세.결론 PTSD 환자대뇌결구완정성하강,행인핵화액중회뇌구개변가능시기정감화기억공능장애적결구기출.
Purpose To explore the brain structural integrity of patients with posttraumatic stress disorders (PTSD) by using diffusion tensor imaging (DTI), and to evaluate the relationship between integrity change and clinical symptoms. Materials and Methods DTI was performed on ten PTSD patients who experienced traffic accident and ten non-PTSD controls who had the same experience. Fractional anisotropy (FA) and mean diffusivity (MD) were compared between PTSD patients and non-PTSD controls by using voxel-based analysis (VBA). Linear correlation analysis was employed to detect the relationship between FA, MD and PTSD checklist-civilian version (PCL-C) scores. Results Compared with non-PTSD group, FA of PTSD group significantly decreased in bilateral middle frontal gyrus, right superior frontal gyrus and left putamen (P<0.01). MD of PTSD group increased mainly in bilateral middle frontal gyrus, anterior cingulate cortex, left amygdala, left insula and left globus pallidus (P<0.01). Negative correlation trend was observed between PCL-C scores and FA in the right middle frontal gyrus of PTSD patients (r=―0.628, P>0.05). Positive correlation trend was observed between MD and PCL-C scores in the right middle frontal gyrus and the left amygdale (r=0.630, r=0.632, P>0.05). Conclusion The abnormalities in amygdala and middle frontal gyrus may be the structural foundation of dysfunction of emotion and memory in patients with PTSD.