本文關(guān)鍵詞： 首發(fā) 精神分裂癥 靜息態(tài) 低頻振幅 默認網(wǎng)絡(luò)　出處：《南京醫(yī)科大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的 近年來功能磁共振成像技術(shù)(functional magnetic resonance imaging,fMRI)研究精神分裂癥,主要采用功能連接的數(shù)據(jù)分析方法,已有大量研究通過這個方法得出精神分裂癥是一種功能連接異常的疾病。功能連接是從時間上相關(guān)腦區(qū)的活動異常來闡明精神分裂癥患者的可能發(fā)病機制,不能直接說明某個腦區(qū)自發(fā)活動的情況。低頻振幅方法能反映大腦靜息態(tài)下局部腦區(qū)活動的異常。本研究通過對首發(fā)精神分裂癥患者與健康對照進行比較,通過使用低頻振幅(Amplitude of Low Frequency Fluctuation, ALFF)和低頻振幅比率(Fractional Amplitude of Low Frequency Fluctuation, fALFF)的方法分析,并同時排除了病程和藥物對靜息態(tài)磁共振數(shù)據(jù)的影響,研究首發(fā)精神分裂癥患者在靜息態(tài)下局部腦區(qū)活動的改變情況。方法 將符合美國《精神障礙診斷與統(tǒng)計手冊第四版》(Diagnostic and Statistical Manua of Mental Disorders, Fourth edition, DSM-IV)中精神分裂癥的診斷標準入組精神分裂癥患者,本研究收集的精神分裂癥患者還必須符合首次發(fā)病且未用藥的標準。對27例首發(fā)精神分裂癥患者(患者組)和22例性別、年齡及受教育程度與患者組相匹配的健康對照(健康對照組),使用3.0T功能磁共振,進行全腦靜息態(tài)功能磁共振成像(resting state functional magnetic resonance imaging, Rs-fMRI)掃描,數(shù)據(jù)掃描的當天先由一名主治醫(yī)師評估精神分裂癥患者的陰性與陽性癥狀量表(positive and negative symptom scale, PANSS)分。對Rs-fMRI數(shù)據(jù)采用SPM8軟件進行預(yù)處理,本研究中頭動平移lmm和旋轉(zhuǎn)移動1。的被試者將被刪除。對于預(yù)處理后的數(shù)據(jù)采用Rest1.6軟件進行靜息態(tài)下各局部腦區(qū)ALFF和fALFF的差異分析。為比較患者組和健康對照組在靜息態(tài)下全腦局部腦區(qū)的ALFF和fALFF的改變情況,將處理后的兩組ALFF和fALFF圖像分別進行雙樣本t檢驗。在體素水平時取單個體素P0.01,連續(xù)體素數(shù)18的腦區(qū),再行蒙特卡羅模擬法Alphaism矯正,校正后當t2.36時,P0.05,這些異常的腦區(qū)就認為是差異有統(tǒng)計學(xué)意義的區(qū)域。 結(jié)果 1.ALFF結(jié)果 1.1.與健康對照組相比,患者組ALFF顯著增高的腦區(qū)是運動前區(qū)、輔助運動區(qū)和眶額回(P0.05, Alphaism矯正)。 1.2.與健康對照組相比,患者組ALFF顯著降低的腦區(qū)是楔前葉、后扣帶回、內(nèi)側(cè)前額葉和角回,差異均有統(tǒng)計學(xué)意義(P0.05, Alphaism矯正)。 2.fALFF結(jié)果 2.1.與健康對照組相比,患者fALFF顯著增高的腦區(qū)是眶額回(P0.05,Alphaism矯正)。 2.2.與健康對照組相比,患者組fALFF顯著降低的腦區(qū)是楔前葉、后扣帶回、左背外側(cè)前額葉和左角回,差異均有統(tǒng)計學(xué)意義(P0.05, Alphaism矯正)。 結(jié)論 1.首發(fā)精神分裂癥患者在靜息態(tài)下存在運動前區(qū)、輔助運動區(qū)、眶額回、楔前葉、后扣帶回、內(nèi)側(cè)前額葉、角回和左背外側(cè)前額葉的局部腦區(qū)異常。 2.本研究同時使用ALFF和fALFF方法對同一批數(shù)據(jù)進行分析,使用這兩種方法分析都發(fā)現(xiàn)首發(fā)精神分裂癥患者存在眶額回、楔前葉、后扣帶回和角回的異常,得出的結(jié)果可靠性高。 3.這些異常的腦區(qū)涉及默認網(wǎng)絡(luò)及任務(wù)正激活網(wǎng)絡(luò)。 4.這些異常的腦區(qū)可能有助于解釋精神分裂癥的病理機制。
[Abstract]:objective
In recent years, functional magnetic resonance imaging (functional magnetic resonance imaging, fMRI) of schizophrenia research, mainly uses the data of functional connectivity analysis method, a large number of studies have been obtained by this method of schizophrenia is a disorder of a connecting function. Function is connected from the time of brain regions related to abnormal events to clarify the spirit the possible pathogenesis in patients with schizophrenia, not directly explain the spontaneous activity in a brain region. The low-frequency amplitude method can reflect the abnormal brain resting state brain activity. This study was conducted to compare patients with first-episode schizophrenia and healthy controls by using low frequency amplitude (Amplitude of Low Frequency Fluctuation, ALFF) low frequency and amplitude ratio (Fractional Amplitude of Low Frequency Fluctuation, fALFF) method of analysis, and also ruled out the course of disease and drugs on The influence of resting state magnetic resonance data to study the changes in the local brain activity in the resting state of the first schizophrenic patients.
The United States will comply with the "diagnostic and Statistical Manual of mental disorders Fourth Edition (Diagnostic and Statistical Manua > of Mental Disorders, Fourth edition, DSM-IV) in diagnostic criteria for schizophrenia in patients with schizophrenia, this study collected the patients with schizophrenia must also comply with the first onset and no drug standard. In 27 cases patients with first-episode schizophrenia (patient group) and 22 cases of sex, age and education level and patients matched healthy controls (healthy control group), the use of 3.0T functional magnetic resonance imaging, whole brain resting state functional magnetic resonance imaging (resting state functional magnetic resonance imaging, Rs-fMRI) scanning, the first one physicians assess mental data scan in patients with positive and negative schizophrenia symptoms scale (positive and negative symptom scale, PANSS). The Rs-fMRI data with SPM8 software The pretreatment, this study head LMM translation and rotation movement of 1. subjects will be deleted. The preprocessed data analysis of difference between ALFF and fALFF of the brain of resting state by Rest1.6 software. In order to change the situation between patients and healthy controls in the resting state brain local the brain region of ALFF and fALFF, two groups of ALFF and fALFF after image processing were two sample t test. Take single voxel P0.01 at the voxel level, the 18 prime continuum brain regions, and the Monte Carlo simulation method Alphaism correction after correction, when t2.36, P0.05, the abnormal brain area is that there was a statistically significant difference in area.
Result
1.ALFF results
Compared with the healthy control group, the brain area of ALFF in the patient group was significantly higher than that in the premotor area and the auxiliary motor area and the orbital frontal gyrus (P0.05, Alphaism correction) in the patient group.
Compared with the healthy control group, the ALFF area of the 1.2. group was significantly lower than that of the healthy control group, the difference was statistically significant (P0.05, Alphaism correction).
2.fALFF results
Compared with the health control group, the significantly higher brain area of the patients with fALFF was the orbital frontal gyrus (P0.05, Alphaism correction).
Compared with the healthy control group, the fALFF area of the 2.2. group was significantly lower than that of the healthy control group, the difference was statistically significant (P0.05, Alphaism correction).
conclusion
1., in the resting state, there were abnormalities in the premotor area, the supplementary motor area, the orbital frontal gyrus, the anterior cingulate lobe, the posterior cingulate cortex, the medial prefrontal cortex, the angular gyrus and the left lateral prefrontal cortex in the first episode schizophrenic patients.
2., this study used ALFF and fALFF to analyze the same data. Using these two methods, we found that there were abnormalities in orbital frontal gyrus, wedge anterior, posterior cingulate gyrus and angular gyrus in first episode schizophrenics, and the results were reliable.
3. these abnormal brain areas involve the default network and the task is activating the network.
4. these abnormal brain regions may help to explain the pathological mechanism of schizophrenia.

【學(xué)位授予單位】：南京醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R749.3

【共引文獻】

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