CAJ | 학술논문

目的探讨精神分裂症患者脑静息态默认网络、中心执行网络及突显网络的网络内及网络间的功能连接特点.方法对74例精神分裂症患者(患者组)和79名相匹配的健康者(对照组)进行静息态fMRI扫描.采取功能连接分析方法,以内侧前额叶皮质及右侧前岛叶为感兴趣区域分别提取默认网络、中心执行网络及突显网络,分析3个网络内及网络间静息态功能连接情况;并对有差异的功能连接与精神症状及病程等进行偏相关分析.结果与对照组相比,患者组内侧前额叶皮质与双侧背外侧前额叶皮质(左侧-0.02±0.18与-0.12±0.12,t=4.25,P＜0.01;右侧-0.02±0.11与-0.10±0.10,t=5.40,P＜0.01)、双侧豆状壳核(左侧0.14±0.12与0.04±0.10,t=5.03,P＜0.01;右侧0.13±0.11与0.03±0.98,t=4.96,P＜0.01)的功能连接增强;右侧前岛叶与左侧额中回(-0.05±0.17与-0.07±0.17,t=4.60,P＜0.01)及楔前叶/后扣带回(0.01±0.13与-0.09±0.14,t=4.01,P＜0.01)的功能连接增强(均采用高斯随机场理论校正,体素水平P＜0.01,簇水平P＜0.05);默认网络与中心执行网络、突显网络间的负向功能连接减小甚至消失(Bonferroni校正P＜0.05).患者组PANSS阳性症状分与右侧前岛叶与楔前叶/后扣带回皮质间的功能连接呈正相关(r=0.232,P=0.025);患者组病程与右侧前岛叶与左侧额中回(r=0.288,P=0.007)、楔前叶/后扣带回(r=0.196,P=0.049)间的功能连接呈正相关.结论精神分裂症患者存在静息态默认网络、中心执行网络及突显网络3个网络间的连接异常,可能与精神分裂症的病理机制有关.
목적 탐토정신분렬증환자뇌정식태묵인망락、중심집행망락급돌현망락적망락내급망락간적공능련접특점.방법 대74례정신분렬증환자(환자조)화79명상필배적건강자(대조조)진행정식태fMRI소묘.채취공능련접분석방법,이내측전액협피질급우측전도협위감흥취구역분별제취묵인망락、중심집행망락급돌현망락,분석3개망락내급망락간정식태공능련접정황;병대유차이적공능련접여정신증상급병정등진행편상관분석.결과 여대조조상비,환자조내측전액협피질여쌍측배외측전액협피질(좌측-0.02±0.18여-0.12±0.12,t=4.25,P＜0.01;우측-0.02±0.11여-0.10±0.10,t=5.40,P＜0.01)、쌍측두상각핵(좌측0.14±0.12여0.04±0.10,t=5.03,P＜0.01;우측0.13±0.11여0.03±0.98,t=4.96,P＜0.01)적공능련접증강;우측전도협여좌측액중회(-0.05±0.17여-0.07±0.17,t=4.60,P＜0.01)급설전협/후구대회(0.01±0.13여-0.09±0.14,t=4.01,P＜0.01)적공능련접증강(균채용고사수궤장이론교정,체소수평P＜0.01,족수평P＜0.05);묵인망락여중심집행망락、돌현망락간적부향공능련접감소심지소실(Bonferroni교정P＜0.05).환자조PANSS양성증상분여우측전도협여설전협/후구대회피질간적공능련접정정상관(r=0.232,P=0.025);환자조병정여우측전도협여좌측액중회(r=0.288,P=0.007)、설전협/후구대회(r=0.196,P=0.049)간적공능련접정정상관.결론 정신분렬증환자존재정식태묵인망락、중심집행망락급돌현망락3개망락간적련접이상,가능여정신분렬증적병리궤제유관.
Objective To explore the neural profile of functional connectivity of default mode network (DMN),central-executive network(CEN),and salience network (SN) in patients with schizophrenia during a resting-state functional magnetic resonance imaging(rs-fMRI).Methods The SPM8,DPARSFA,CONN softwares combined with data-driven region of interest (ROI) analysis were used to investigate functional connectivity (FC) of the DMN,CEN,and SN in 74 patients with schizophrenia (SZ) and 79 ageand gender-matched normal controls (NC).Medial prefrontal cortex (MPFC) was selected as seed region for identifying the DMN and CEN while right anterior insula (rAI) for the SN.Voxel-wise functional connectivity analyses were performed between MPFC and rAI while pair-wise functional connectivity analyses were conducted across DMN,CEN,and SN.Results Concerning the MPFC,SZ showed increased functional connectivity,comparing with NC,with bilateral dorsolateral prefrontal cortex (left:-0.02 ±0.18 vs.-0.12± 0.12,t=4.25,P＜0.01;right:-0.02±0.11 vs.-0.10±0.10,t=5.40,P＜0.01) and bilateral putamen (left:0.14± 0.12 vs.0.04±0.10,t=5.03,P＜0.01;right:0.13±0.11 vs.0.03±0.98,t=4.96,P＜0.01).With regard to rAI,increased functional connectivity between rAI and left middle frontal cortex (-0.05±0.17 vs.-0.07±0.17,t=4.60,P＜0.01) and between rAI and precuneus/posterior cingulate cortex (0.01±0.13 vs.-0.09±0.14,t=4.01,P＜0.01) were found in SZ comparison to NC (gaussian random field thaeory-corrected;voxel level P＜0.01,cluster level P＜0.05).Additionally,SZ also showed enhanced interconnectivity strengths of DMN-CEN and DMN-SN (Bonferroni-corrected,P＜0.05).Furthermore,partial correlation analyses showed that the increased functional connectivity between rAI and precuneus/posterior cingulate cortex was significantly correlated with PANSS-positve symptoms (r-0.232,P=0.025).Positive relationships were found between the duration of illness and functional connectivity between rAI and left middle frontal cortex (r=0.288,P=0.007) and between rAI and precuneus/posterior cingulate cortex (r=0.196,P=0.049).Conclusions This study provides evidence for resting state functional connectivity abnormalities of DMN,CEN,and SN in patients with schizophrenia.These aberrant functional connectivities between some key brain regions of three networks may be responsible for certain schizophrenic symptoms,which could contribute to exploring the pathophysiological mechanisms of schizophrenia.