基于体素形态学脑灰质体积改变及静息态比率低频振幅分析首发精神分裂症青年患者
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摘要
目的观察首次发病且未经治疗的精神分裂症(SZ)青年患者脑灰质体积及神经元生理活动强度变化。方法收集首次发病且未经治疗的38例SZ青年患者(SZ组)及40名健康志愿者(对照组),采用基于体素形态学(VBM)DARTEL法分析全脑灰质体积变化,以静息态比率低频振幅(fALFF)法分析脑神经元生理活动强度变化,提取组间有差异脑区的数据,并分析其与患者临床资料的相关性。结果与对照组比较,SZ患者左侧额上回、右侧扣带回中部灰质体积缩小,右侧额上回、右侧额中回fALFF降低,双侧前扣带回fALFF增高。SZ患者阳性症状评分与首次发病年龄呈正相关(r=0.34,P=0.03)。结论首次发病的SZ青年患者存在额叶及扣带回灰质结构与功能异常。
Objective To observe the changes of brain gray matter volume and the neural physiologic spontaneous activity strength in young patients with the first episode and untreated schizophrenia(SZ).Methods Totally 38 young patients with the first episode and untreated SZ(SZ group)and 40 matched normal controls(control group)were enrolled.The changes of brain gray matter volume and neural physiological activity strength were analyzed using voxel-based morphological(VBM)DARTEL method and resting-state fractional amplitude of low-frequency fluctuation(fALFF)methods.Correlation analysis was performed among extracted data from brain regions with significant differences and clinical data of SZ patients.Results Compared with control group,the brain regions with decreased gray matter were seen in left superior frontal cortex and right middle cingulate gyrus in SZ group.The regions with decreased fALFF included right superior and medial frontal cortex,and those with increased fALFF were found with bilateral anterior cingulate gyrus in SZ group.The score of positive symptoms was positively related to episode age(r=0.34,P=0.03).ConclusionChanges both of gray matter structure and function exist in frontal cortex and cingulate gyrus in young patients with the first episode SZ.
Objective To observe the changes of brain gray matter volume and the neural physiologic spontaneous activity strength in young patients with the first episode and untreated schizophrenia(SZ).Methods Totally 38 young patients with the first episode and untreated SZ(SZ group)and 40 matched normal controls(control group)were enrolled.The changes of brain gray matter volume and neural physiological activity strength were analyzed using voxel-based morphological(VBM)DARTEL method and resting-state fractional amplitude of low-frequency fluctuation(fALFF)methods.Correlation analysis was performed among extracted data from brain regions with significant differences and clinical data of SZ patients.Results Compared with control group,the brain regions with decreased gray matter were seen in left superior frontal cortex and right middle cingulate gyrus in SZ group.The regions with decreased fALFF included right superior and medial frontal cortex,and those with increased fALFF were found with bilateral anterior cingulate gyrus in SZ group.The score of positive symptoms was positively related to episode age(r=0.34,P=0.03).ConclusionChanges both of gray matter structure and function exist in frontal cortex and cingulate gyrus in young patients with the first episode SZ.
引文
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[13]Rosa PG,Zanetti MV,Duran FL,et al.What determines continuing grey matter changes in first-episode schizophrenia and affective psychosis?Psychol Med,2015,45(4):817-828.
[14]Fraguas D,Merchán-Naranjo J,del Rey-Mejías,et al.Alongitudinal study on the relationship between duration of untreated psychosis and executive function in early-onset firstepisode psychosis.Schizophr Res,2014,158(1-3):126-133.
[2]Zhu J,Wang C,Liu F,et al.Alterations of functional and structural networks in schizophrenia patients with auditory verbal hallucinations.Front Hum Neurosci,2016,10:114.
[3]Lobbestael J,Leurgans M,Arntz A.Inter-rater reliability of the structured clinical interview for DSM-IV axisⅠdisorders(SCIDⅠ)and axisⅡdisorders(SCIDⅡ).Clin Psychol Psychother,2011,18(1):75-79.
[4]邹文锦,邓文皓,林鄞,等.双相情感障碍Ⅰ型早期阶段青年患者静息态低频振幅研究.中国医学影像技术,2015,31(7):976-980.
[5]Egashira K,Matsuo K,Mihara T,et al.Different and shared brain volume abnormalities in late-and early-onset schizophrenia.Neuropsychobiology,2014,70(3):142-151.
[6]Kim G,Kim Y,Jeong G.Whole brain volume changes and its correlation with clinical symptom severity in patients with schizophrenia:A DARTEL-based VBM study.PLoS One,2017,12(5):e177251.
[7]邹寄林,陈诚,黄欢,等.不同阶段精神分裂症病人灰质体积的改变.武汉大学学报(医学版),2016,37(2):288-292.
[8]Guo W,Yao D,Jiang J,et al.Abnormal default-mode network homogeneity in first-episode,drug-naive schizophrenia at rest.Prog Neuropsychopharmacol Biol Psychiatry,2014,49:16-20.
[9]Guo W,Liu F,Liu J,et al.Abnormal causal connectivity by structural deficits in first-episode,drug-naive schizophrenia at rest.Schizophr Bull,2014,41(1):57-65.
[10]Schneider M,Walter H,Moessnang C,et al.Altered DLPFC-hippocampus connectivity during working memory:Independent replication and disorder specificity of a putative genetic risk phenotype for schizophrenia.Schizophr Bull,2017,43(5):1114-1122.
[11]Zheng L,Liu W,He W,et al.Altered effective brain connectivity at early response of antipsychotics in first-episode schizophrenia with auditory hallucinations.Clin Neurophysiol,2017,128(6):867-874.
[12]Anticevic A,Savic A,Repovs G,et al.Ventral anterior cingulate connectivity distinguished nonpsychotic bipolar illness from psychotic bipolar disorder and schizophrenia.Schizophr Bull,2015,41(1):133-143.
[13]Rosa PG,Zanetti MV,Duran FL,et al.What determines continuing grey matter changes in first-episode schizophrenia and affective psychosis?Psychol Med,2015,45(4):817-828.
[14]Fraguas D,Merchán-Naranjo J,del Rey-Mejías,et al.Alongitudinal study on the relationship between duration of untreated psychosis and executive function in early-onset firstepisode psychosis.Schizophr Res,2014,158(1-3):126-133.