首發(fā)精神分裂癥腦白質(zhì)彌散張量成像研究
發(fā)布時(shí)間：2018-09-14 08:06
【摘要】：背景：白質(zhì)完整性是保持腦功能連接正常的結(jié)構(gòu)基礎(chǔ)。以往研究已表明精神分裂癥存在腦區(qū)異常,而越來越多的證據(jù)支持精神分裂癥更可能是一種腦區(qū)連接異常疾病。因此精神分裂癥可能存在一定程度的白質(zhì)纖維結(jié)構(gòu)異常,但目前國內(nèi)外相關(guān)研究尚存在較多爭議。 目的：(1)運(yùn)用彌散張量成像技術(shù)(DTI)和基于纖維束的空間統(tǒng)計(jì)方法(TBSS)探討首發(fā)未服藥精神分裂癥患者的腦白質(zhì)纖維束結(jié)構(gòu)的異常；(2)探討首發(fā)未服藥精神分裂癥患者的白質(zhì)纖維束異常與其精神病癥狀和認(rèn)知功能的關(guān)系；(3)呈現(xiàn)首發(fā)精神分裂癥患者與健康被試存在差異區(qū)域的立體纖維重建。 方法：根據(jù)嚴(yán)格標(biāo)準(zhǔn)納入27例精神分裂癥患者和20例年齡、性別相匹配的健康被試,使用陽性與陰性量表(PANSS)評(píng)估患者精神病癥狀,使用連線測(cè)驗(yàn)(TMT)、Stroop測(cè)驗(yàn)、威斯康星卡片分類測(cè)驗(yàn)(WCST)、停止信號(hào)任務(wù)(SST)和動(dòng)態(tài)記憶任務(wù)等五種神經(jīng)心理學(xué)測(cè)驗(yàn)評(píng)定患者和健康人的認(rèn)知功能。對(duì)兩組被試進(jìn)行DTI掃描,使用FSL5.0軟件進(jìn)行TBSS分析,比較兩組被試腦白質(zhì)纖維的部分各向異性(FA)。再提取兩組被試FA有顯著差異的白質(zhì)纖維束的FA值,使用SPSS18.0計(jì)算FA與PANSS與神經(jīng)心理測(cè)驗(yàn)得分的相關(guān)關(guān)系。最后,使用Diffusion Toolkit和Trackvis重建兩組被試差異區(qū)的白質(zhì)纖維。 結(jié)果：(1)首發(fā)未服藥精神分裂癥患者的雙側(cè)胼胝體體部、左側(cè)胼胝體膝部、右側(cè)輻射冠前區(qū)、雙側(cè)輻射冠上部、右側(cè)內(nèi)囊前肢、左側(cè)扣帶FA值顯著小于正常對(duì)照組(p0.05)；(2)除停止信號(hào)任務(wù)之外,首發(fā)未服藥精神分裂癥患者在連線測(cè)驗(yàn)、Stroop測(cè)驗(yàn)、威斯康星卡片分類測(cè)驗(yàn)、動(dòng)態(tài)記憶任務(wù)中的得分與正常對(duì)照組有顯著差異(p0.05)；(3)首發(fā)未服藥精神分裂癥患者的PANSS總分與其全腦平均FA呈顯著負(fù)相關(guān)(r=-0.39,p=0.04),PANSS陰性癥狀分與輻射冠上部FA呈顯著正相關(guān)(r=0.44,p=0.02),停止信號(hào)任務(wù)的反應(yīng)信號(hào)反應(yīng)時(shí)與胼胝體體部FA (r=-0.48, p=0.02)、右側(cè)內(nèi)囊前肢FA呈顯著負(fù)相關(guān)(r=-0.42,p=0.04),Stroop測(cè)驗(yàn)顏色-字矛盾條件下的讀字?jǐn)?shù)與輻射冠上部FA呈顯著正相關(guān)(r=0.43,p=0.03),威斯康星卡片分類測(cè)驗(yàn)的正確應(yīng)答數(shù)與左側(cè)扣帶束FA呈顯著正相關(guān)(r=0.54,p=0.01)。(4)首發(fā)精神分裂癥患者的胼胝體體部平均纖維長度顯著短于正常組(p0.05)。 結(jié)論：(1)首發(fā)未服藥精神分裂癥患者的腦白質(zhì)受到損傷,損傷區(qū)域主要包括：雙側(cè)胼胝體體部、左側(cè)胼胝體膝部、右側(cè)輻射冠前區(qū)、雙側(cè)輻射冠上部、左側(cè)扣帶、右側(cè)內(nèi)囊前肢；(2)首發(fā)未服藥精神分裂癥患者的腦白質(zhì)損傷與其疾病癥狀和認(rèn)知功能缺陷存在顯著相關(guān)關(guān)系；(3)精神分裂癥患者的腦白質(zhì)損傷在疾病早期已經(jīng)出現(xiàn),可能是神經(jīng)纖維脫髓鞘的結(jié)果。
[Abstract]:Background: White matter integrity is the structural basis for maintaining normal brain functional connections. Previous studies have shown that schizophrenia has abnormal brain regions, and more evidence supports that schizophrenia is more likely to be an abnormal brain area connection disease. Therefore, there may be some abnormalities in the structure of white matter fibers in schizophrenia, but there is still much controversy at home and abroad. Objective: (1) to investigate the abnormal structure of white matter fiber bundle in patients with first-episode schizophrenia by using diffusion-Zhang Liang imaging technique (DTI) and spatial statistical method based on fiber bundle (TBSS). (2) to explore the relationship between abnormal white matter fiber bundle and mental symptoms and cognitive function in first-episode schizophrenic patients, and (3) to explore the reconstruction of stereoscopic fibers in patients with first-episode schizophrenia and healthy subjects. Methods: according to the strict criteria, 27 schizophrenic patients and 20 healthy subjects of age and sex were included. The positive and negative (PANSS) were used to evaluate the psychiatric symptoms of the patients, and the (TMT) Stroop test was used to test the psychosis symptoms. Wisconsin card sorting test (WCST), stop signal task (SST) and dynamic memory task five neuropsychological tests were used to assess the cognitive function of patients and healthy persons. Two groups of subjects were scanned by DTI and TBSS was analyzed by FSL5.0 software. The partial anisotropic (FA). Of white matter fibers was compared between the two groups. The FA value of white matter fiber bundle with significant difference in FA was extracted from the two groups. The correlation between FA and PANSS and the score of neuropsychological test was calculated by SPSS18.0. Finally, Diffusion Toolkit and Trackvis were used to reconstruct the white matter fibers in the difference area between the two groups. Results: (1) the FA values of bilateral corpus callosum, left genu of corpus callosum, right anterior coronal area, upper part of bilateral radiative crown, anterior limb of right internal capsule and left cingulate zone in patients with first-episode schizophrenia were significantly lower than those in control group (p0.05). (2) in addition to the task of stopping signal, the scores of first-episode patients without medication in Stroop test, Wisconsin card sorting test and dynamic memory task were significantly different from those in normal control group (p0.05). (3) there was a significant negative correlation between the total score of PANSS and the average FA of the whole brain in patients with first-episode schizophrenia (r-0.39, p0.04). There was a significant positive correlation between the score of negative symptoms of PANSS and the FA of the upper part of the radiative crown (r = 0.44, p0. 02). The response signal response to stop the signal task was associated with the corpus callosum. FA (r-0.48, p0. 02) and FA of the right anterior limb of the internal capsule were negatively correlated (r-0. 42 p0. 04). There was a significant positive correlation between the number of words read under the condition of color-word contradiction in the Stroop test and the FA in the upper part of the radiometric crown (r 0. 43 p0. 03). The correct response number of Wisconsin card sorting test was positively correlated with the FA of the left cingulate band. The average fiber length of corpus callosum in first-episode schizophrenia patients was significantly shorter than that in normal controls (P 0.05). Conclusion: (1) the white matter was injured in patients with first-episode non-medication schizophrenia. The main areas of injury included bilateral corpus callosum, left genu of corpus callosum, right anterior coronal area, upper part of bilateral radiative corona and left cingulate band. The anterior limb of the right internal capsule; (2) the white matter injury in patients with first-episode non-medication schizophrenia was significantly correlated with the symptoms of the disease and cognitive impairment; (3) the white matter damage of the schizophrenic patients had already appeared in the early stage of the disease. This may be the result of demyelination of nerve fibers.
【學(xué)位授予單位】：中南大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R749.3
本文編號(hào)：2242077
[Abstract]:Background: White matter integrity is the structural basis for maintaining normal brain functional connections. Previous studies have shown that schizophrenia has abnormal brain regions, and more evidence supports that schizophrenia is more likely to be an abnormal brain area connection disease. Therefore, there may be some abnormalities in the structure of white matter fibers in schizophrenia, but there is still much controversy at home and abroad. Objective: (1) to investigate the abnormal structure of white matter fiber bundle in patients with first-episode schizophrenia by using diffusion-Zhang Liang imaging technique (DTI) and spatial statistical method based on fiber bundle (TBSS). (2) to explore the relationship between abnormal white matter fiber bundle and mental symptoms and cognitive function in first-episode schizophrenic patients, and (3) to explore the reconstruction of stereoscopic fibers in patients with first-episode schizophrenia and healthy subjects. Methods: according to the strict criteria, 27 schizophrenic patients and 20 healthy subjects of age and sex were included. The positive and negative (PANSS) were used to evaluate the psychiatric symptoms of the patients, and the (TMT) Stroop test was used to test the psychosis symptoms. Wisconsin card sorting test (WCST), stop signal task (SST) and dynamic memory task five neuropsychological tests were used to assess the cognitive function of patients and healthy persons. Two groups of subjects were scanned by DTI and TBSS was analyzed by FSL5.0 software. The partial anisotropic (FA). Of white matter fibers was compared between the two groups. The FA value of white matter fiber bundle with significant difference in FA was extracted from the two groups. The correlation between FA and PANSS and the score of neuropsychological test was calculated by SPSS18.0. Finally, Diffusion Toolkit and Trackvis were used to reconstruct the white matter fibers in the difference area between the two groups. Results: (1) the FA values of bilateral corpus callosum, left genu of corpus callosum, right anterior coronal area, upper part of bilateral radiative crown, anterior limb of right internal capsule and left cingulate zone in patients with first-episode schizophrenia were significantly lower than those in control group (p0.05). (2) in addition to the task of stopping signal, the scores of first-episode patients without medication in Stroop test, Wisconsin card sorting test and dynamic memory task were significantly different from those in normal control group (p0.05). (3) there was a significant negative correlation between the total score of PANSS and the average FA of the whole brain in patients with first-episode schizophrenia (r-0.39, p0.04). There was a significant positive correlation between the score of negative symptoms of PANSS and the FA of the upper part of the radiative crown (r = 0.44, p0. 02). The response signal response to stop the signal task was associated with the corpus callosum. FA (r-0.48, p0. 02) and FA of the right anterior limb of the internal capsule were negatively correlated (r-0. 42 p0. 04). There was a significant positive correlation between the number of words read under the condition of color-word contradiction in the Stroop test and the FA in the upper part of the radiometric crown (r 0. 43 p0. 03). The correct response number of Wisconsin card sorting test was positively correlated with the FA of the left cingulate band. The average fiber length of corpus callosum in first-episode schizophrenia patients was significantly shorter than that in normal controls (P 0.05). Conclusion: (1) the white matter was injured in patients with first-episode non-medication schizophrenia. The main areas of injury included bilateral corpus callosum, left genu of corpus callosum, right anterior coronal area, upper part of bilateral radiative corona and left cingulate band. The anterior limb of the right internal capsule; (2) the white matter injury in patients with first-episode non-medication schizophrenia was significantly correlated with the symptoms of the disease and cognitive impairment; (3) the white matter damage of the schizophrenic patients had already appeared in the early stage of the disease. This may be the result of demyelination of nerve fibers.
【學(xué)位授予單位】：中南大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R749.3
【參考文獻(xiàn)】
相關(guān)期刊論文 前2條
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2 司天梅,楊建中,舒良,王希林,孔慶梅,周沫,李雪霓,劉粹;陽性和陰性癥狀量表(PANSS,中文版)的信、效度研究[J];中國心理衛(wèi)生雜志;2004年01期
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