【摘要】 目的探讨精神分裂症患者丘脑及其相关网络连接是否存在异常及脑功能连接对执行表现的影响。方法采用血氧水平依赖性功能磁共振成像方法,在静息和2-back任务状态下检测14例偏执型精神分裂症患者和16名正常志愿者的脑功能连接,将前额叶内侧皮层(MPFC,BA10)作为种子点,应用SPM2、AFNI及Matlab软件进行图像数据处理,分别对患者组和正常对照组的2-back任务和静息状态行组内和组间两个水平的统计分析,统计阈值概率设定为P=0.005(未校正)。结果正常对照组在静息状态时,与MPFC正相关的功能连接脑区主要分布在左侧丘脑前核、双额上回内侧(BA6)、右胼胝体下部(伏隔核)(BA34)及小脑蚓部等,患者组主要分布在双前额叶内侧回(BA9/10);正常对照组在2-back任务时,与MPFC负相关的功能连接脑区主要分布在左侧丘脑背侧、双侧运动前区外侧(BA6)、左顶下小叶/楔前叶(BA7)、右侧小脑半球,患者组主要分布在右侧小脑半球、左顶上小叶/楔前叶(BA7)、左额上回(BA6)。正常对照组的反应正确率高于患者组[(89.89±8.05)%vs.(78.30±8.76)%,P=0.01],其执行正确率与左侧丘脑背侧的相关性有统计学意义(r=-0.52,P=0.04)。结论丘脑前核和背侧部在功能上分属不同系统。精神分裂症患者在静息状态时左侧丘脑前核-右侧伏隔核功能连接减低,2-back任务时左侧丘脑背侧部与前额叶、顶叶-小脑的功能连接减低,可能是精神分裂症患者执行能力低下的原因之一。更多还原

【Abstract】 Objective To investigate the thalamus and its related network of the schizophrenia patients and its correlation to behavior performance with functional magnetic resonance imaging.Methods Fourteen patients with paranoid schizophrenia and sixteen normal subjects received blood oxygenation level dependent functional magnetic resonance imaging(BOLD-fMRI) examinations based on resting state and digital 2-back working memory task.The fMRI data were processed and analyzed with SPM2,AFNI and Matlab software packages(thresholded at P = 0.005,uncorrected).Medial prefrontal cortex(MPFC,BA10) was placed as region of interest(ROI).Results In the resting state,the brain areas positively correlated with MPFC were mainly distributed in the left anterior nucleus thalamus,bilateral medial superior frontal gyrus(BA6),right inferior corpus callosum(nucleus accumbens)(BA34) and the cerebellar vermis for control group and in the bilateral medial prefrontal gyrus(BA9 /10) for patient group.In the 2-back task,the brain areas negatively correlated with MPFC were mainly distributed in the left medial dorsal thalamus,bilateral lateral premotor area(BA6),left inferior parietal lobule / precuneus(BA7),right cerebellar hemisphere for control group and in the right cerebellar hemisphere,left superior parietal lobule / precuneus(BA7),left superior frontal gyrus(BA6) for patient group.The accuracy of reaction was higher in control group than that in patient group[89.89 ±8.05) % vs.(78.30 ± 8.76) %,P = 0.01]and the correlation between the accuracy and the left medial dorsal thalamus has statistical significance(r =- 0.52,P = 0.04).Conclusions The functions of anterior nucleus thalamus and medial dorsal thalamus are different.The connectivity between the left anterior nucleus thalamus and accumbens reduce in patients with schizophrenia in the resting state.The reduced functional connection between left medial dorsal thalamus and prefrontal-parietal lobe-cerebellum in the 2-back task state may be the one reason of poor behavior performance in schizophrenia patients.更多还原