本文關(guān)鍵詞： 運動障礙 藥源性 磁共振成像 皮質(zhì)形態(tài) 精神分裂癥　出處：《中國心理衛(wèi)生雜志》2017年07期 　論文類型：期刊論文

【摘要】：目的:分析伴發(fā)遲發(fā)性運動障礙(TD)精神分裂癥患者大腦皮質(zhì)形態(tài)學特征及其與異常不自主運動嚴重程度間的關(guān)聯(lián),探討TD發(fā)生可能的病理機制。方法:研究納入伴發(fā)TD精神分裂癥患者(TD組)32例、不伴發(fā)TD精神分裂癥患者(非TD組)31例及健康對照(對照組)21例,TD和非TD組合并為精神分裂癥組。分別采用陽性和陰性癥狀量表(PANSS)、異常不自主運動量表(AIMS)評估患者的精神病理和異常不自主運動癥狀;用磁共振成像技術(shù)采集頭顱磁共振成像數(shù)據(jù),應用Freesurfer軟件計算大腦皮質(zhì)體積、厚度、表面積及皮質(zhì)下結(jié)構(gòu)體積,比較3組間皮質(zhì)形態(tài)學差異。結(jié)果:精神分裂癥組右伏隔核、雙海馬、左額上回、左中央前上溝皮質(zhì)體積以及左中央前上溝表面積比對照組小;TD組較非TD組右伏隔核體積小,左中央前上溝皮質(zhì)體積、表面積大(均P0.05);以氯丙嗪當量和PANSS陰性癥狀分為協(xié)變量進行協(xié)方差分析,TD組左中央前上溝皮質(zhì)體積、表面積仍較非TD組大[(2.03±0.07)×10~3mm~3 vs.(1.68±0.07)×10~3 mm~3,(1.01±0.03)×10~3 mm~2 vs.(0.84±0.03)×10~3 mm~2;均P0.05]。相關(guān)分析結(jié)果顯示,精神分裂癥組右額下回皮質(zhì)厚度與PANSS陽性癥狀分、一般病理分負相關(guān),與PANSS總分正相關(guān);左枕顳側(cè)溝皮質(zhì)體積與PANSS一般病理分、PANSS總分負相關(guān);右額下回皮質(zhì)體積與PANSS陽性癥狀分正相關(guān);右頂內(nèi)溝頂橫溝皮質(zhì)體積與PANSS陽性癥狀分正相關(guān)。TD組AIMS總分與左中央前上溝皮質(zhì)體積正相關(guān)(r=0.46,P0.01)。結(jié)論:TD患者左中央前上溝皮質(zhì)體積、表面積增加,且與TD癥狀嚴重程度有關(guān);左中央前上溝在TD的發(fā)病機制中可能起運動補償作用。
[Abstract]:Objective: to analyze the morphological features of cerebral cortex and its relationship with the severity of abnormal involuntary motor movement in schizophrenic patients with delayed dyskinesia. Methods: 32 patients with TD schizophrenia were enrolled in this study. Patients without TD schizophrenia (31 cases in non-TD group and 31 cases in healthy control group) were assessed with positive and negative symptom scale (PANSS) and abnormal involuntary exercise scale (AIMS) respectively. Psychopathology and abnormal involuntary motor symptoms; The volume, thickness, surface area and subcortical structure volume of cerebral cortex were calculated by Freesurfer software, and the morphological differences of cortex were compared among the three groups. Results: right accumbent septum nucleus in schizophrenia group. The volume of bilateral hippocampus, left superior frontal gyrus, left precentral superior sulcus cortex and surface area of left precentral superior sulcus were smaller in TD group than in non-TD group, and the volume of left precentral superior sulcus cortex in TD group was smaller than that in non-TD group. The surface area of TD group was larger than that of non-TD group (2.03 鹵0.07) 脳 10 ~ 3mm ~ (3 vs.(1.68 鹵0.07) 脳 10 ~ (3) vs.(1.68 鹵0.07) 脳 10 ~ (3) 鹵0.03 mm ~ (-1) 脳 10 ~ (3) mm ~ (-3) 脳 10 ~ (3) mm ~ (-3) 脳 10 ~ (3) mm ~ (-2) 脳 10 ~ (3) mm ~ (-2) 脳 10 ~ (-3) mm ~ (-2) 脳 10 ~ (-3) mm ~ (-2). The results of correlation analysis showed that the surface area of TD group was still larger than that of non-TD group [2.03 鹵0.07) 脳 10 ~ 3 mm ~ 3 鹵0.07]. In the schizophrenia group, the thickness of the right inferior frontal cortex was negatively correlated with the positive symptoms of PANSS, the general pathological score was negatively correlated with the total score of PANSS, and the cortical volume of the left occipito-temporal sulcus was negatively correlated with the total score of PANSS. The cortical volume of right subfrontal gyrus was positively correlated with the positive score of PANSS, the cortical volume of right medial sulcus was positively correlated with the score of PANSS positive symptoms. The total score of AIMS in TD group was positively correlated with the volume of left precentral superior sulcus cortex. The surface area is increased and is related to the severity of TD symptoms, and the left precentral sulcus may play a role in motor compensation in the pathogenesis of TD.
【作者單位】： 北京回龍觀醫(yī)院北京大學回龍觀臨床醫(yī)學院;北京大學第六醫(yī)院北京大學精神衛(wèi)生研究所衛(wèi)生部精神衛(wèi)生學重點實驗室(北京大學);
【基金】：北京市自然科學基金重點項目(7151005)
【分類號】：R749.3

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