计算机化认知矫正治疗对精神分裂症脑白质弥散张量的影响

详细信息    查看官网全文

• 英文论文题名：Brain effects of Computerized Cognitive Remediation Therapy in schizophrenia:A diffusion tensor imaging study
• 论文作者：张开元 ; 杨永秀 ; 申变红 ; 朱春燕 ; 施剑飞
• 英文论文作者：Zhang Kai-yuan ; Yang Yong-xiu ; Shen Bian-hong ; Mental rehabilitation group ; the Seventh People's Hospital of Hangzhou
• 年：2014
• 作者机构：Mental rehabilitation group,the Seventh People's Hospital of Hangzhou;
• 论文关键词：认知矫正治疗 ; 精神分裂症 ; 弥散张量
• 英文论文关键词：cognitive remediation ; schizophrenia ; diffusion tensor imaging
• 会议召开时间：2014-11-20
• 会议录名称：2014浙江省医学会精神病学分会学术年会、浙江省医师协会精神科医师分会第七届年会论文汇编
• 语种：中文
• 分类号：R749.3
• 学会代码：ZJKX
• 会议名称：2014浙江省医学会精神病学分会学术年会、浙江省医师协会精神科医师分会第七届年会
• 会议地点：中国浙江湖州
• 主办单位：浙江省医学会精神病学分会（The Society of Psychiatry ; ZJMA）、浙江省医师协会精神科医师分会
• 学会名称：浙江省科学技术协会
• 页数：5
• 文件大小：522k
• 原文格式：O
• 会议级别：地方

摘要

目的采用DTI技术探讨CCRT对精神分裂症患者脑区白质纤维完整性的影响。方法选取34例精神分裂症患者(患者组)和34例与患者组性别、年龄、受教育程度相匹配的志愿者(对照组)进行CCRT训练和DTI扫描,比较训练前后胼胝体压部及膝部、前扣带、小脑中脚及小脑上脚的FA值。结果患者组双侧前扣带、双侧胼胝体压部以及左侧小脑上脚FA值较对照组降低,差异有统计学意义(P<0.01或P<0.05);而在双侧胼胝体膝部、双侧小脑中脚及右侧小脑上脚与对照组无差异(P>0.05)。患者组经CCRT后上述ROIs的FA值较治疗前无明显差异(P>0.05)。结论慢性精神分裂症患者存在双侧前扣带、双侧胼胝体压部以及左侧小脑上脚纤维完整性异常,CCRT能有效改善患者的认知功能,但对慢性病程长期住院的患者脑白质完整性影响不大。
Objectivre To investigate the white matte integrity changes after computerized cognitive remediation therapy.Methods DTI was performed in 34 schizophrenia patients and 34 gender,age,and education matched controls.FA was measured in ROIs(anterior cingulated,genu and splenium of corpus callosum,superior and middle cerebellar peduncles) before and after CCRT.Results Patient group had significantly reduced FA in the bilateral anterior cingulate,bilateral splenium of corpus callosum,left superior cerebellar peduncles compared with control group(P<0.01 or P<0.05);FA of the patient group had no changes after CCRT.Conclusion There are white matter integrity deficits in several brain regions that may involved in the neuropathology of schizophrenia,and these changes is not sensitive to CCRT in chronic patients.

引文

[1]Jones D K,Leemans A.Diffusion tensor imaging[M]//Magnetic Resonance Neuroimaging.Humana Press,2011:127-144.
    [2]Magnotta V A,Adix M L,Caprahan A,et al.Investigating connectivity between the cerebellum and thalamus in schizophrenia using diffusion tensor tractography:a pilot study[J].Psychiatry Research:Neuroimaging,2008,163(3):193-200.
    [3]王颖,贾艳滨,凌雪英,等.精神分裂症首次发作患者的脑扩散张量成像[J].中华精神科杂志,2008,41(2):73-76.
    [4]谭淑平,邹义壮,王健,等.认知矫正治疗慢性精神分裂症患者认知功能缺陷的随机对照研究[J].中华精神科杂志,2010,43(3):140-145.
    [5]Bozikas VP,Andreou C.Longitudinal Studies of Cognition in First Episode Psychosis:A Systematic Review of the Literature.Aust N Z J Psychiatry,2011,45(2):93-108.
    [6]Shamsi S,Lau A,Lencz T,etal.Cognitive and symptomatic predictors of functional disability in schizophrenia.Schizophrenia Researched 1,126(1):257-264.
    [7]Goldberg TE,Goldman RS,Burdick KE,et al:Cognitive improvement after treatment with second-generation antipsychotic medications in first-episode schizophrenia:is it a practice effect?Archives of General Psychiatry,2007,64:1115-1122.
    [8]Ramnani N,Behrens TE,Penny W,et al.New approaches for exploring anatomical and functional connectivity in the human brain.Bio psychiatry,2004,56:613-619.
    [9]Taylor KS,Seminowicz DA,Davis KD.Tow systems of resting state connectivity between the insula and cingulate cortex.Human Brain Mapp,2009,30:2731-2745..
    [10]Kubicki M,Westin CF,Nestor PG,et al.Cingulate fasciculus integrity disruption in schizophrenia:a magnetic resonance diffusion tensor imaging study.Biol-paychiatry,2003,54:1171-1180.
    [11]Whifford TJ,Kubicki M,Schneiderman JS,et al.Corpus callosum abnormalities and their association with psychotic symptoms in patients with schizophrenia.Biol Psychiatry,2010,68:70-77.
    [12]Huttlova J,Kikinis Z,Kerkovsky M,et al.Abnormalities inMyelination of the Superior Cerebellar Peduncle in Patients with Schizophrenia and Deficits in Movement Sequencing.The Cerebellum,2014,13(4):415-424.
    [13]Penades R,Pujol N,Catalan R,et al.Brain Effects of Cognitive Remediation Therapy in Schizophrenia:A Structural and Functional Neuroimaging Study.BIOL PSYCHIATRY 2013,73:1015-1023.
    [14]Takeuchi H,Sekiguchi A,Taki Y,et al.Training of working memory impacts structural connectivity.J Neurosci,2010,30:3297-3303..
    [15]Bor J,Brunelin J,Amato T,et al.How can cognitive remediation therapy modulate brain activations in schizophrenia:A fMRI study Psychiatry Research:Neuroimaging.2011,192(3):160-165.
    [16]Eack SM,Hogarty GE,Cho RY,et al.Neuroprotective Effects of Cognitive Enhancement Therapy Against Gray Matter Loss in Early Schizophrenia.Arch Gen Psychiatyr,2010,67(7):674-682.
    [17]Ho BC,Andreasen NC,Ziebell S,et al.Long-term Antipsychotic Treatment and Brain Volumes:A Longitudinal Study of FirstEpisode Schizophrenia.Arch Gen Psychaitry,2011,68:128-137.
    [18]Fitzsimmons J,Kubicki M,Shenton M.Review of functional and anatomical brain connectivity findings in schizophrenia.Current Opinion in Psychiatry,2013,26(2):172-187.