首发精神分裂症患者倒背数字作业的fMRI研究  

Functional magnetic resonance imaging of backward digit span task in first-episode schizophrenic patients

作　　者：刘登堂[1] 徐一峰[1] 凌政[1] 刘含秋[2] 姚振宇[2] 江开达[1] 

机构地区：[1]上海市精神卫生中心精神科,200030 [2]复旦大学附属华山医院放射科

出　　处：《上海精神医学》2004年第5期258-262,共5页Shanghai Archives of Psychiatry

摘　　要：目的　利用功能磁共振成像 (fMRI)探讨首发精神分裂症患者倒背数字作业激发图像的特点。方法　 36例符合ICD 10诊断标准的 (首发 )精神分裂症患者及 18名健康志愿者进行以倒背数字作业 (backwarddigitspantask ,BDST)作为刺激模式、采用组块 (block)设计的fMRI检查 ,经工作站处理后获功能图像。用阳性和阴性症状量表 (PANSS)评价精神分裂症患者精神症状的严重程度。结果　(1)健康志愿者与精神分裂症患者激活脑区的范围均较广泛 ,健康志愿者的左侧额上回、双侧额中回、左侧额下回、左侧中央前回、左侧顶上小叶、左侧缘上回、左侧颞下回及左侧枕颞外侧回等脑区均有明显激活。两组激活的脑区在额叶、颞叶、顶叶、枕叶及扣带回的分布 ,以及各脑区内部分布的差异均没有显著性 (P >0 .0 5 )。 (2 )健康志愿者与精神分裂症患者激活计数 :左侧额上回分别为 16和 11,左侧额下回分别为 15和 12 ,左侧中央前回分别为 16和 17,左侧颞下回分别为 14和 12 ,左侧顶上小叶分别为 14和14 ,左侧缘上回分别为 14和 7,左侧枕颞外侧回分别为 14和 7,右侧中央前回分别为 13和 7,右侧枕颞外侧回分别为 11和 8,两组上述部位激活计数的差异均有显著性 (P均 <0 .0 5 )。 (3)健康志愿者与精神分裂症患者左侧额叶背外侧的激活平均体?Objective: To explore the characteristics of functional areas of backward digit span task (BDST) by using blood oxygenation level dependent functional magnetic resonance imaging (BOLD-fMRI) in first-episode schizophrenic patients. Methods: 36 drug-naive patients who met with the 10th edition of International Classification of Disease criteria for schizophrenia and 18 healthy volunteers were recruited in the study and fulfilled the fMRI. A block-design paradigm with 6 blocks was applied and the whole brain fMRI were collected as they performed a BDST 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 middle frontal gyri, left superior frontal gyrus, inferior frontal gyrus,precentral gyrus, superior parietal lobe,supramarginal gyrus, inferior temporal gyrus and occipitotemporalis lateralis gyrus. And the similar activation distributions 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 healthy volunteers and schizophrenic patients were respectively 16 and 11 in left superior frontal gyrus, 15 and 12 in left inferior frontal gyrus, 16 and 17 in left precentral gyrus, 14 and 12 in left inferior temporal gyrus, 14 and 14 in left superior parietal lobe, 14 and 7 in left supramarginal gyrus, 14 and 7 in left occipitotemporalis lateralis gyrus, 13 and 7 in right precentral gyrus, 11 and 8 in right occipitotemporalis lateralis gyrus, and the differences between healthy volunteers and schizophrenic patients were significant (P<0.05). (3) The activated volume in healthy volunteers and schizophrenic patients were respectively (362±296)voxels and(79±101)voxels in left dorsolateral frontal cortex (DLFC), (448±273)voxels and (193±236) voxels in right posterior parietal cor

关 键 词：左侧 精神分裂症患者 激活 健康志愿者 额叶 脑区 首发精神分裂症 显著性 中央 范围 

分 类 号：R749.3[医药卫生—神经病学与精神病学] R6[医药卫生—临床医学]