精神分裂症患者等级伦敦塔任务的近红外光谱成像研究  

A multi-channel near-infrared spectroscopy study on prefrontal activation during the graded Tower of London in schizophrenia

作　　者：刘琳琳[1] 王惠玲[1] 王熇生[1] 苏德振[1] 陈诚[1] 吴士豪[1] 杨灿[1] 王高华[1] 牛海晶[2] 蒋田仔[3] 

机构地区：[1]武汉大学人民医院精神卫生中心,430060 [2]北京师范大学认知神经科学与学习国家重点实验室 [3]中国科学院自动化所模式识别实验室

出　　处：《中华精神科杂志》2012年第6期321-326,共6页Chinese Journal of Psychiatry

摘　　要：目的比较精神分裂症患者与健康人在不同难度等级伦敦塔（the Tower of London，TOL）认知任务下的脑区激活程度和模式的差异。方法利用功能性近红外光谱成像技术（thnctional near infrared spectroscopy，fNRS），记录30例精神分裂症患者（患者组）和30名健康对照（对照组）在fNIRS仪不同难度等级的TOL任务下双侧前额叶皮质血红蛋白浓度的变化；以阳性与阴性症状量表评分评定患者组的精神症状。结果（1）患者组较对照组在各难度等级的TOL测验上的正确答题数少，反应时间长（P均〈0．05）。（2）激活程度比较：患者组在各难度等级TOL任务下前额叶皮质激活均弱于对照组（P〈0．05）。（3）激活模式比较：中间的前额叶皮质：对照组的激活程度为中等任务〉容易任务〉困难任务[容易、中等及刖难仟务期氧合血红蛋白的差值（Aoxy—Hb）分别为4．05±4．89、5．93±3．94、2．12±1．78，P〈0．05]，患者组不同难度TOL任务下激活程度差异无统计学意义（P〉0．05）；背外侧前额叶皮质：对照组不同难度TOL任务下激活程度差异无统计学意义（P〉0．05），患者组随着任务难度的增加其激活程度降低（容易、中等及困难任务期Aoxy—Hb分别为5．19±9．12、3．24±6．74、0．01±0．82，P〈0．05）。结论精神分裂症患者存在前额叶功能低下。Objective To investigate the executive function as well as the characteristics of the activation in the prefrontal cortex （ PFC ） of schizophrenia patients during the graded Tower of London test. Methods Near-infrared spectroscopy （NIRS） was used to assess hemoglobin concentration changes in the bilateral PFCs during the TOL tasks （ at different levels of difficulty） in 30 schizophrenia patients and 30 age- and gender-matched healthy controls. The Positive and Negative Syndrome Scale （PANSS） was used to assess the psychiatric symptoms of the patients. Results （ 1 ） The numbers of the correct answers of all the three difficulty levels of TOL in the schizophrenia group were less than that of the control group, while the response time were longer than that of the latter. （2） The majority of the prefrontal areas of the normal controls were significantly activated during TOL task. And compared with the controls, the patients were characterized by significant decreased activation in the bilateral PFC during all levels of the TOL tasks （ P 〈 0. 05）. （3） The activation patterns of the two groups were different. The activations in middle areas of the prefrontal cortex in the normal controls were medium 〉 easy 〉 difficult （the Aoxy-Hb of easy, medium and difficult were 4.05 ＋4. 89,5.93 ±3.94 and 2. 12 ± 1.78 respectively,P 〈0. 05）. In the patients, there was no significant difference among the different levels of TOL （ P 〉 0. 05 ） . There was no differences on activations in dorsolateral prefrontal cortex in the normal controls among the different levels of TOL （P 〉 0. 05 ） , while for the patients, with the increasing of the difficulty of the TOL tasks, the activations were reduced instead （ the Aoxy-Hb of easy, medium and difficult were 5. 19 ± 9. 12,3. 14 ±6. 74 and 0.01± 0. 82 respectively, P 〈 0. 05 ）. Conclusion Schizophrenia patients have executive dysfunction, which may be explained by PFC dysfunction. The results further support that schizophreni

关 键 词：精神分裂症 额叶前皮质 谱学 近红外线 伦敦塔 

分 类 号：R749.3[医药卫生—神经病学与精神病学]