创伤后应激障碍患者脑结构完整性的变化:扩散张量成像研究  

Diffusion Tensor Imaging in Detecting the Brain Structural Integrity of Patients with Posttraumatic Stress Disorder

作　　者：张静娜[1] 邱明国[1] 谢兵[2] 李敏[3] 张佳佳[3] 张钰[3] 

机构地区：[1]第三军医大学生物医学工程与医学影像学院医学信息与医学图像学教研室,重庆400038 [2]第三军医大学西南医院放射科,重庆400038 [3]第三军医大学护理学院心理学教研室,重庆400038

出　　处：《中国医学影像学杂志》2013年第1期1-4,共4页Chinese Journal of Medical Imaging

基　　金：国家自然科学基金项目(30870696;31170994);第三军医大学回国人员启动基金项目(2009XHG01);重庆市自然科学基金项目(CSTC2009BB5019)

摘　　要：目的运用扩散张量成像(DTI)技术检测创伤后应激障碍(PTSD)患者脑结构完整性的变化及其与临床症状间的关系。资料与方法 10例交通伤后应激障碍患者和10例无应激障碍的交通事故亲历者进行DTI扫描,应用基于体素的分析方法比较两组受试者的部分各向异性分数(FA)值和平均扩散系数(MD),并分析有差异脑区的FA值和MD值与创伤后应激障碍自评量表(PCL-C)评分之间的相关性。结果与无应激障碍者比较,PTSD患者双侧额中回、右侧额上回及左侧壳核FA值显著降低(P<0.01),双侧额中回、前扣带回及左侧杏仁核、脑岛、苍白球的MD值显著增高(P<0.01)。PTSD患者右侧额中回FA值与PCL-C评分无明显相关性(r=-0.628,P>0.05),但呈负相关趋势;右侧额中回及左侧杏仁核MD值与PCL-C评分无明显相关性(r=0.630,P>0.05;r=0.632,P>0.05),但呈正相关趋势。结论 PTSD患者大脑结构完整性下降,杏仁核和额中回脑区改变可能是其情感和记忆功能障碍的结构基础。Purpose To explore the brain structural integrity of patients with posttraumatic stress disorders （PTSD） by using diffusion tensor imaging （DTI）, and to evaluate the relationship between integrity change and clinical symptoms. Materials and Methods DTI was performed on ten PTSD patients who experienced traffic accident and ten non-PTSD controls who had the same experience. Fractional anisotropy （FA） and mean diffusivity （MD） were compared between PTSD patients and non-PTSD controls by using voxel- based analysis （VBA）. Linear correlation analysis was employed to detect the relationship between FA, MD and PTSD checklist-civilian version （PCL-C） scores. Results Compared with non-PTSD group, FA of PTSD group significantly decreased in bilateral middle frontal gyrus, right superior frontal gyrus and left putamen （P〈0.01）. MD of PTSD group increased mainly in bilateral middle frontal gyrus, anterior cingulate cortex, left amygdala, left insula and left globus pallidus （P〈0.01）. Negative correlation trend was observed between PCL-C scores and FA in the right middle frontal gyrus of PTSD patients （r=-0.628, P〉0.05）. Positive correlation trend was observed between MD and PCL-C scores in the right middle frontal gyrus and the left amygdale （r=0.630, r=0.632, P〉0.05）. Conclusion The abnormalities in amygdala and middle frontal gyrus may be the structural foundation of dysfhnction of emotion and memory in patients with PTSD.

关 键 词：应激障碍 创伤后 脑损伤 磁共振成像 扩散张量成像 

分 类 号：R742[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]