【摘要】 目的探讨偏执型精神分裂症患者2-back任务状态下的脑区激活特点及其与执行功能表现的关系。方法采用参数性2-back任务,分别检测14例偏执型精神分裂症患者和16名正常志愿者的脑激活情况。应用SPM2软件进行图像数据处理,其中统计阈值P=0.005(未校正),对行为学表现采用SPSS13.0进行统计分析。结果在2-back任务时,患者组额顶叶正激活及负激活脑区的强度均低于正常对照组,但未见较正常对照组激活增强的脑区。行为学表现:患者组和对照组2-back任务的反应时间差异无统计学意义[(935.78±173.18)msvs(845.16±101.07)ms,P>0.05],但患者组的反应正确率低于对照组[(78.30±8.76)%vs(89.89±8.05)%,P=0.01];患者组低于对照组的正激活脑区与患者组的反应正确率呈正相关(r为0.41～0.63),但只有右顶上小叶和右尾状核分别与正确率之间的相关有统计学意义(P<0.05);低于对照组的负激活脑区与患者组的反应正确率呈负相关但无统计学意义(r为-0.17～-0.35,P均大于0.05)。结论偏执型精神分裂症患者额顶叶正激活减弱与执行功能表现差有关;负激活减弱可能与执行功能表现差、注意转换效率低下或无效有关。更多还原

【Abstract】 Objective To investigate the differences of activation or deactivation between paranoid schizophrenic patients and normal subjects with digital 2-back working memory task and its correlation to behavior performance.Methods Fourteen patients with paranoid schizophrenia and sixteen normal subjects received functional MR examinations with digital 2-back working memory task.The fMRI data were processed with SPM2 and the behavior performance data were analyzed with SPSS13.0.Results The activation and deactivation in frontal and parietal lobe were all decreased in schizophrenic patients compared to normal subjects.The reaction time was longer in patients than in normal subjects[(935.78±173.18)ms vs(845.16±101.07)ms,P>0.05].The accuracy rate decreased in schizophrenic subjects compared to normal controls[(78.30±8.76)% vs(89.89±8.05)%,P=0.01].The accuracy rate was positively correlated to the activation regions(r ranged 0.41~0.63)and there were statistical significance of the correlation just in right superior parietal lobule and right caudate nucleus(P<0.05).The accuracy slightly negatively correlated to the deactivation regions(r ranged-0.17~-0.35,P>0.05)which showed discrepancy in patient group and normal controls.Conclusions The results indicate that the low behavioral performance contributes to hypoactivation of frontal and parietal lobe of paranoid schizophrenic patients.Decreased deactivation in schizophrenic patients may relate to poor performance and inefficiency of attention conversion between resting state and task performing.更多还原