【作者】 李岩；

【导师】 田红军；

【作者基本信息】 天津医科大学 ， 临床医学（专业学位）， 2021， 硕士

【摘要】 目的 采用独立成分分析及格兰杰因果分析技术探究精神分裂症患者静息状态下脑功能特征,并考察这些特征与临床症状相关性。方法 采用西门子Skyra3.0T MRI扫描平台收集患者的结构和功能相位数据;针对精分患者使用阳性和阴性症状量表来评价其临床症状的严重性;采用独立成分分析定义感兴趣区,采用格兰杰因果分析(Granger causality analysis,GCA)评估大脑的效应连接,应用DPARSF进行图像预处理,应用REST进行格兰杰因果分析,采用双样本T检验比较所有被试在不同种子点下检验到的脑效应连接差异,在此基础上考察患者组与对照组之间效应连接差异脑区与临床指标之间的相关性。结果 共获取MRI数据质量合格的41例精神分裂症患者样本和30例健康对照样本数据。(1)双侧颞上回的格兰杰因果分析:双侧颞上回到全脑其他脑区的效应连接(X2Y):相较于健康对照组,精神分裂症患者双侧颞上回到右侧枕上回/枕中回、双侧顶上回的效应连接增强;全脑其他脑区至双侧颞上回的连接(Y2X):精神分裂症患者与健康对照组相比,其右枕上回至两侧颞上回的效应连通性降低。(2)丘脑至全脑脑区的效应联通性(X2Y):精神分裂症患者与健康对照组相比,其丘脑至双侧楔前叶及左顶上回的效应连通性提高。全脑其他脑区到丘脑的效应连接(Y2X):相较于健康对照组,精神分裂症患者双侧楔前叶、左侧中央旁小叶、右侧中央后回到丘脑的效应连接减弱,双侧尾状核到丘脑的效应连接增强。皮尔逊相关显示,以左侧颞上回为种子点,左侧颞上回到右侧顶上回的效应连接与精分患者精神科用药(氯丙嗪当量)呈显著负相关(r=-0.361,P=0.02);以右侧颞上回为种子点,右侧颞上回到右侧顶上回的效应连接与精分患者精神科用药(氯丙嗪当量)也呈显著负相关(r=-0.361,P=0.02)。结论 精神分裂症患者的两侧颞上回至枕上回/枕中回、顶上回以及右侧枕上回到双侧颞上回的效应连接相较于健康对照发生改变;精神分裂症患者丘脑到双侧楔前叶、左侧顶上回的效应连接及双侧楔前叶、左侧中央旁小叶、右侧中央后回到丘脑的效应连接异常,尾状核到丘脑的效应连接增强。更多还原

【Abstract】 Objectives Using independent component analysis and granger causality analysis to characterize the brian resting-state brain activity features of patients with schizophrenia.Methods Simens-Skyra 3.0T MRI was adopted to acquire the samples’ MRI data.Positive and negative symptoms scale(PANSS)was used to assess the illness severity of patients with schizophrenia.Independent component analysis was adopted to define regions of interest.Granger causality analysis was adopted to to calculate the effective connection.We calculated voxel-wise granger causality analysis by REST software.Two-sample t-test was used to access the difference of effective connection between two groups.Pearson correlation was utilized to explore the correlation between effective connection and clinical features.Results MRI-qualified forty-one patients with schizophrenia and thirty healthy controls were performed analysis in the present study.(1)Granger causality analysis of bilateral superior temporal gyrus: the effective connection of bilateral superior temporal gyrus to other regions of the whole brain(X2Y): The effective connection from the bilateral superior temporal gyrus to right superior occipital gyrus/middle occipital gyrus and bilateral superior parietal gyrus were significantly increased;the effective connection from the whole brain to the bilateral superior temporal gyrus(Y2X): Compared with the healthy controls,the effective connection from the right superior occipital gyrus to the bilateral superior temporal gyrus were significantly decreased.(2)Granger causality analysis of thalamus to other brain regions of the whole brain(X2Y):Compared with healthy controls,the effective connection from the thalamus to bilateral precuneus and left superior parietal gyrus is enhanced.The effectual connection from other brain areas of the whole brain to the thalamus(Y2X):Compared with the healthy control group,effective connection from the bilateral precuneus,the left paracentral lobule and the right postcentral gyrus to the thalamus were significantly decreased.The effective connection from the caudate nucleus to the thalamus is enhanced.Pearson correlation analysis showed that the effective connection of the bilateral superior temporal gyrus to the right superior parietal gyrus was significantly negatively correlated with the psychiatric medication(chlorpromazine equivalent)(r=-0.361,P=0.02).Conclusion The patients had abnormal effective connections from bilateral superior temporal gyrus to superior occipital gyrus/middle occipital gyrus,and superior parietal gyrus,and abnormal effective connections from the right superior occipital gyrus to bilateral superior temporal gyrus;The patients had abnormal effective connections from thalamus to precuneus and left superior parietal gyrus,and abnormal effective connections from the bilateral precuneus,the left paracentral lobule,and the right postcentral gyrus to the thalamus.The effective connections from caudate to the thalamus are enhanced.更多还原