【摘要】 目的 采用低频振幅(ALFF)指标评估偏执型精神分裂症患者静息态脑功能活动及其与妄想临床症状之间的关系。方法 采集14例偏执型精神分裂症患者及14例与其相匹配的健康人的静息态fMR1图像。用阳性症状和阴性症状量表(PANSS)及妄想特征等级量表(CDRS)对患者的精神症状进行评估。通过DPARSF软件使用体素为基础的方法来计算ALFF,用REST 1.8软件对ALFF和CDRS、PANSS妄想分量表分数进行相关分析。结果 观察组相关分析显示左侧外侧核、右侧小脑山顶和左侧额上回内侧与CDRS成负相关(AlphaSim校正,P<0.05)。用和未用PANSS总分作为协变量,均未发现ALFF与PANSS量表妄想分的显著相关性。在相关脑区里,疾病组和健康对照组的两独立样本t检验显示右侧颞上回和左侧额上回内侧的ALFF值在疾病组比健康对照组高(AlphaSim校正,P<0.05)。左侧额上回内侧的ALFF值与CDRS的“干扰”条目具有显著相关性(P=0.039),与其他条目未发现显著相关。右侧颞上回与CDRS条目未发现显著相关。结论 左侧外侧核、右侧小脑山顶和左侧额上回内侧ALFF值与妄想的严重程度的显著相关性提示偏执型精神分裂症患者在上述区域存在与妄想有关的功能异常。右侧颞上回和左侧额上回内侧ALFF值的升高可能对偏执型精神分裂症患者妄想的形成具有特殊的作用。ALFF可能为精神分裂症机制的研究提供了一个客观指标。更多还原

【Abstract】 Objective The low-frequency amplitude(ALFF)index was used to assess the resting brain function of patients with paranoid schizophrenia and its relationship with delusional clinical symptoms.Methods 14 paranoid schizophrenia patients and 14 matched health controls were underwent scanning on a 1.5 T Siemens scanner to get resting-state images.The positive and negative symptoms scale(PANSS)and characteristic delusional rating scale(CDRS)were used to evaluate the symptoms of patients.ALFF was calculated in voxel-based way by DPARSF(Data processing assistant for resting-state fMRI).The correlation between ALFF and CDRS and PANSS-delusion was got by REST 1.8,and age,gender,medication(CPZ)and total PANSS score were all covariants of the correlation.All results were corrected by AlphaSim program of REST 1.8.The difference of ALFF between paranoid schizophrenia patients and health controls was carried out by two sample t-test in the significant brain regions of correlation above.All results were corrected by AlphaSim program of REST 1.8.Further,the correlation between each item score of CDRS and ALFF of significant brain regions of two sample t-test above were calculated.Results The paranoid schizophrenia patients showed negative correlation between ALFF and CDRS in left lateral nucleus,right cerebellar crest and left medial superior frontal gyrus(AlphaSim correction,P<0.05).There was significant correlation between ALFF and PANSS-delusion with and without total PANSS score covariant.In the significant correlated brain regions,paranoid schizophrenia patient showed higher ALFF relative to health controls in left medial superior gyrus and right superior temporal gyrus(AlphaSim correction,P<0.05).The correlation between ALFF ofleft medial superior gyrus and item“interference”of CDRS was significant(r=-0.56,P=0.039).Other items showed no significance.There was no significant correlation between right superior temporal gyrus and items of CDRS.Conclusion The significant correlation between ALFF of left lateral nucleus,right cerebellar crest and left medial superior frontal gyrus and severity of delusion infer that the delusion of paranoid schizophrenia patients may be correlated with dysfunction of brain regions above.The high ALFF ofleft medial superior gyrus and right superior temporal gyrus may be some special work in formation of delusion in paranoid schizophrenia patients.ALFF might be an objective index in the mechanism of schizophrenia.更多还原