摘要
目的应用功能磁共振成像探讨精神分裂症首次发病(以下简称首发)患者词语流畅性作业激发图像的特点。方法以词语流畅性作业作为刺激模式,采用组块设计的功能磁共振成像技术,采集36例符合国际疾病分类第10版诊断标准的精神分裂症首发患者(精神分裂症组)及18名健康志愿者(正常对照组)的功能图像,并进行比较。精神分裂症组中有6例因不合作而被剔除。结果(1)两组激活脑区的范围均较广泛;(2)激活脑区数(个):精神分裂症组双侧额中回(均为16/30)、右额下回(14/30)、右中央前回(11/30)和右扣带回(15/30)等脑区的激活率均小于正常对照组(分别为16/18、16/18、15/18、13/18、15/18),差异有统计学意义(P<0.05);(3)激活脑区体积(体素):精神分裂症组左侧额叶背外侧(118±272)、左侧额叶腹外侧(176±293)、左侧扣带回前上部(142±169)均小于正常对照组(分别为545±809、514±427、279±192),差异有统计学意义(P<0.05)。结论早期精神分裂症患者可能存在长时记忆提取缺陷;搜寻特异目标的缺陷可能与双侧额下回的功能低下有关,对提取内容的核查及管理缺陷可能与双侧额中回的功能低下有关。
Objective To explore the characteristics of functional areas during verbal fluency task by using blood oxygenation level dependent functional magnetic resonance imaging （BOLD-fMRI） in first-episode schizophrenic patients. Methods 36 drug-naive patients met with the 10th edition of International Classification of Disease criteria for schizophrenia and 18 healthy volunteers were recruited in the study. A block-design paradigm with 6 blocks was applied to the paricipants and the whole brain fMRI were collected as they performed a verbal fluency task. The data of activation and rest images were reconstructed with an offline workstation and the activation map was obtained. All the patients were assessed with the Positive and Negative Syndrome Scale （PANSS）. Results （1） Healthy volunteers showed significant activations in bilateral superior frontal gyri, bilateral middle frontal gyri, right inferior frontal gyrus and right anterior cingulate gyrus. And the similar activation maps were also seen in the frontal lobe, temporal lobe, parietal lobe, occipital lobe and cingulate gyrus in the schizophrenic patients. （2） The activated numbers in the controls and schizophrenic patients were respectively 16/18 and 16/30 in left middle frontal gyrus, 16/18 and 16/30 in right middle frontal gyrus, 15/18 and 14/30 in right inferior frontal gyrus, 13/18 and 11/30 in right precentral gyms, 15/18 and 15/30 in right cingulated gyrus. And the differences in the above brain regions between healthy volunteers and schizophrenic patients were significant （P 〈 0.05 ）. （3） The activated volumes in the controls and schizophrenic patients were respectively （545 ± 809） and （118 ± 272）voxels in left dorsolateral frontal cortex, （514 ± 427 ） and （176 ± 293 ） voxels in left ventrolateral frontalcortex, （279 ± 192） and （142 ± 169） voxels in left anterior cingulate gyrus, and the differences between healthy volunteers and schizophrenic patients were significant （ P 〈 0. 05 ）. Conclusion The results indicate that long-term memory deficits may exist during the early stage of schizophrenia, and the hypoactivation in bilateral inferior frontal gyri may be responsible for the specification deficit of search parameters, and the hypoactivation in bilateral middle frontal gyri may be related to the monitoring deficit of the memory researchs.
出处
《中华精神科杂志》
CAS
CSCD
北大核心
2005年第3期138-141,共4页
Chinese Journal of Psychiatry
