精神分裂症执行功能障碍患者工作记忆fMRI研究  

The role of the prefrontal cortex in schizophrenia accompanied by dysexecutive syndromes during the double working memory tasks:an fMRI study

作　　者：吴大兴[1] 谭长连[2] 颜莉蓉[3] 胡德文[3] 王湘[1] 姚树桥[1] 

机构地区：[1]中南大学湘雅二医院医学心理研究中心,湖南长沙410011 [2]中南大学湘雅二医院放射科 [3]国防科技大学机电工程与自动化学院自动控制系

出　　处：《中国医科大学学报》2007年第6期737-740,共4页Journal of China Medical University

基　　金：国家自然科学基金(30100054;30570609);国家杰出青年科学基金(60225015)资助项目

摘　　要：目的:探讨精神分裂症执行功能障碍患者与正常人在执行双重任务工作记忆作业时大脑前额皮质区的激活特征及其异同。方法:采用无创性功能磁共振成像(fMRI)技术观察9例精神分裂症执行功能障碍患者和13名正常人在双重工作记忆作业时大脑前额皮质区激活的位置、范围和强度,用SPM99软件分析。结果:本组精神分裂症患者威斯康星卡片分类测验成绩差,工作记忆作业时反应时延长(P<0.05)。正常组在执行双重任务时激活了左、右前额叶的背外侧区、右额极区、左扣带回前部等脑区。精神分裂症执行功能障碍患者激活明显区域有双侧前额叶背外侧区和右侧腹外侧区,且比正常组范围大。精神分裂症组减正常组,有差异的激活区较为广泛,不仅有左、右前额背外侧区、腹外侧区、额内侧回,而且左、右岛叶(额盖)、右眶额回等区域也有差异,且以右额叶为主。正常组减精神分裂症组只有左背外侧区有差异。结论:精神分裂症执行功能障碍患者前额皮质区在双重任务工作记忆中激活异常。Objective：To investigate the different patterns of the prefrontal cortex（PFC） activities in the phonological and spatial double working memory（WM） tasks between schizophrenia（Sch） inpatients accompanied by dysexecutive syndromes and normal healthy subjects.Methods：Block designed blood oxygenation level dependent functional magnetic resonance imaging（fMRI） was performed on 9 Sch and 13 normal persons,who were asked to conduct the double WM task visually presented on the screen.Function of PFC was assessed by Wisconsin Card Sorting Test（WCST）.The brain activation map was obtained by using SPM99 software.The PFC activation size,intensity,and location of 2 groups were compared.Results：The reaction time delayed,the correct rate and WCST result decreased when patients were undertaking the WM task,which were significantly different from and worse than those in the normal group（P 〈 0.05）.There were significant activation zones in bilateral dorsolateral prefrontal cortex（DLPFC）,right anterior prefrontal cortex（APFC）and left anterior cingulated cortex（ACC） when normal sujects were undertaking double tasks.There were significant activation zones in bilateral DLPFC and the ventrolateral prefrontal cortex（VLPFC） when patients were undertaking double tasks,which were broader than those of the normal subjects.When comparing the control with SCH in double tasks,there was a significant activation zone only in left DLPFC,but when comparing SCH with the control,there were broader significantl activition zones in bilateral DLPFC,VLPFC,medial frontal gyrus（MFG）,insula and right orbito-prefrontal cortex（OPFC）,with right prefrontal cortex dominantly activated.Conclusion：Compared with the normal group,the prefrontal cortex of Sch patients accompanied by dysexecutive syndromes has some functional activation deficits when conducting the double working memory tasks.

关 键 词：前额皮质区 工作记忆 精神分裂症 执行功能障碍 功能磁共振成像 

分 类 号：R749.3[医药卫生—神经病学与精神病学]