运用VBM方法检测创伤后应激障碍患者发病前脑灰质容积的改变  

Brain Structural Abnormalities Prior to the Onset of Post-Traumatic Stress Disorder: A Voxel-Based Morphometry Study

作　　者：孙雅文[1] 王振[2] 周滟[1] 秦玲娣[1] 苏珊珊[2] 路青[1] 陈增爱[1] 许建荣[1] 

机构地区：[1]上海交通大学医学院附属仁济医院放射科,200127 [2]上海交通大学医学院附属精神卫生中心,200030

出　　处：《临床放射学杂志》2012年第6期764-768,共5页Journal of Clinical Radiology

基　　金：国家自然科学基金资助项目(编号:30800370;81171325);上海市浦江人才计划资助项目(编号:09PJ1408900);上海市科委医学引导项目(编号:114119a0900);上海市卫生局科研计划课题资助项目(编号:2009054)

摘　　要：目的运用基于体素的形态学方法(voxel based morphometry,VBM)分析创伤后应激障碍(posttraumaticstress disorder,PTSD)患者是否于发病前即存在脑灰质容积的改变。方法 PTSD危险人群于创伤暴露后2天内行3 T MRI全脑扫描。搜集12例最终确诊的PTSD患者及12例年龄、性别及创伤暴露与之相匹配的对照组的脑结构图像,运用基于SPM5的VBM5进行数据分析,采用双样本t检验,以P<0.001(未校正)、核团体素>35视为差异有统计学意义。结果与对照组相比,PTSD组右侧杏仁核、海马旁回、前扣带回、额上回、颞中回、颞下回,楔前叶、左侧额下回、颞上回、岛叶、中央前回及中脑的灰质容积减少,未发现PTSD组较对照组灰质容积增加的区域。结论创伤暴露初期就能探测出PTSD患者存在与情绪控制、调节及记忆等功能相关的脑灰质结构改变,推测这些改变在创伤前可能已经存在,可能是PTSD的重要致病因素之一。Objective To detect the changes of gray matter volume（GMV） in patients with post-traumatic stress disorder（PTSD） before the onset using voxel-based morphometry （VBM）. Methods All the subjects were scanned on a 3.0T MR system within 2 days after trauma exposed. The magnetic resonance imagings of the brain were acquired from 12 subjects who had PTSD in the end, as well as from 12 age-, gender- and traumatic events-matched healthy controls. Image preprocessing was carried out using VBM implemented on the Statistical Parametric Mapping （ SPM5 ） software package. A second-level two-sample t-test was used to examine the differences of GMV between the two groups （P 〈 0. 001, FDR un- corrected, voxel size 〉 35）. Results Compared with controls, PTSD patients had lower GMV in the right amygdala, right parahippocampal gyrus, right anterior cingulate, right superior frontal gyrus, right middle temporal gyrus, right inferior temporal gyrus, right precuneus, left inferior frontal gyms, left superior temporal gyrus, left insular, left precentral gyrus and left midbrain. No area of significantly decreased GMV was observed in controls in relative to PTSD patients. Conclusion As the changes of brain regions related to emotional control, regulation and memory functions can be identified in pa- tients who go on to develop PTSD after recent trauma, these data could form part of the predisposition to develop PTSD.

关 键 词：创伤后应激障碍 基于体素的形态学分析 磁共振成像 

分 类 号：R749.5[医药卫生—神经病学与精神病学]