创伤后应激障碍患者脑结构的磁共振研究  

A magnetic resonance imaging study of brain structure in post-traumatic stress disorder

作　　者：陈树林[1] 刘军[1] 李凌江[1] 夏薇薇[2] 胡德文[2] 张锦黎[1] 

机构地区：[1]中南大学湘雅二医院精神卫生研究所 [2]国防科技大学机电工程与自动化学院自动控制系

出　　处：《中华精神科杂志》2006年第1期9-11,共3页Chinese Journal of Psychiatry

基　　金：国家自然科学基金资助项目(30470621);教育部博士点基金资助项目(20030533022);湖南省自然科学基金资助项目(03JJY3055)

摘　　要：目的探讨创伤后应激障碍(PTSD)患者是否存在大脑结构形态学的改变。方法对12例因火灾事故而致PTSD患者(PTSD组)、12名年龄、性别和创伤暴露均与PTSD组相匹配的正常人(对照组)进行MRI扫描,获取脑结构的T1加权像和3维图像,进行基于像素的形态测量学分析,比较两组灰质、白质密度的异同。结果在控制了年龄和性别的影响后,PTSD组与对照组灰质密度比较的差值,在左侧海马(TALAIRACH坐标:X=-26MM,Y=-13MM,Z=-17MM,T=5·05)、左侧前扣带回(X=-2MM,Y=40MM,Z=17MM,T=5·06)和双侧岛叶(右侧岛叶X=34MM,Y=4MM,Z=6MM,T=4·64;左侧岛叶X=-34MM,Y=4MM,Z=6MM,T=4·44)的差异有统计学意义(P<0·001);两组在其他脑区灰质或白质密度的差异无统计学意义。结论创伤后应激障碍患者的海马、前扣带回和岛叶都有灰质密度的减少,提示这些脑区的结构存在病理性改变。Objective To investigate the possible changes of brain structural morphometry in patients with post-traumatic stress disorder （PTSD）. Methods Twelve patients with PTSD caused by a fire disaster were involved, and 12 gender-, age-matched healthy persons who exposed the same fire disaster were selected as controls. Brain structural images including T1 and 3D images were gained by magnetic resonance imaging scan. Then structural images were dealt with voxel-based morphometry using the Statistical Parametric Mapping software （ SPM2 ） to compare the differences in gray and white matter between the two groups. Results In comparison with controls, the PTSD patients had less gray-matter density in left hippocampus, left anterior cingulate cortex （Brodmann＇s area 32）, and bilateral insulars （Brodmann＇a area 13 ） （P 〈0. 001 ）. The intensities in other gray matter regions and the white matter regions did not show any significant differences between two groups. Conclusion The results suggest that there may be morphometric changes in brain areas including left hippocampus, left anterior cingulate cortex and bilateral insulars in patients with PTSD.

关 键 词：应激障碍 创伤后 磁共振成像 脑 

分 类 号：R749.5[医药卫生—神经病学与精神病学]