双相障碍I型患者脑默认网络的研究  

Abnormal functional connectivity of default mode network in patient with bipolar Ⅰ disorder

作　　者：王鹏[1] 薛志敏[1] 张会然[1] 吴国伟[1] 曹龙龙[1] 胡爱民[1] 刘畅[1] 贺忠[2] 刘哲宁[1] 

机构地区：[1]中南大学湘雅二医院精神卫生研究所,长沙410011 [2]中南大学湘雅二医院精神卫生研究所放射科,长沙410011

出　　处：《中华精神科杂志》2013年第5期262-266,共5页Chinese Journal of Psychiatry

基　　金：国家自然科学基金（81171287.30971053）

摘　　要：目的 通过对双相障碍Ⅰ型患者字母匹配任务（n-back任务）下脑负激活网络的分析,探讨双相障碍患者工作记忆缺陷的神经机制.方法 对14例双相障碍Ⅰ型患者（病例组）和20名性别、年龄、受教育年限均匹配的健康人（对照组）进行临床评估和字母匹配任务（n-back任务）下的功能磁共振扫描,通过组内和组间统计分析得到两组的任务相关负激活脑区分布,并比较两组的差异.结果 病例组韦氏智测数字符号测验成绩显著低于对照组（71.93±15.81比87.80±14.81,P=0.005）,并在0-back任务正确率（0.87±0.17比0.97±0.04,P=0.051）和2-back任务正确率（0.64±0.19比0.77±0.18,P=0.050）上较对照组显示出较强的降低趋势.两组的负激活脑区分布与人类脑默认网络基本一致,病例组在双侧楔前叶、左侧后扣带比对照组存在更强的负激活（未校正,P＜0.001,像素集合＞40）.结论 默认网络的异常可能是双相障碍的生物学特征,可能与患者的工作记忆损害有关.Objective To explore whether the deactived brain areas in patients with bipolar Ⅰ disorder exhibits abnormal functional connectivity and helps to explain the neural mechanism of work memory impairment in these patients.Methods Fourteen patients with bipolar Ⅰ disorder and twenty matched healthy subjects underwent clinical assessments which included the n-back task,and functional magnetic resonance imaging （fMRI） scan.One-sample and independent-samples t test was used to identify the DMN and compare the activities of DMN between groups.Results The patient group scored significantly lower in WAIS digit symbol-coding test （71.93 ± 15.81 vs.87.80 ± 14.81,P =0.005） than the control group,alsoshowed a strong decreasing trend in 0-back accuracy （0.87 ± 0.17 vs.0.97 ± 0.04,P =0.051） and 2-back accuracy（0.64 ±0.19 vs.0.77 ±0.18,P =0.050）.Analysis of imaging data identified the DMN well in both the patient and control group,consistent with prior literature.The patients with bipolar Ⅰ disorder exhibited significantly stronger deactivation than the healthy subjects in bilateral precuneus and left posterior cingulate cortex （Unadjusted,P 〈 0.001,cluster 〉 40）.Conclusion Abnormalities in DMN connectivity with the PrC/PCC may be a biological trait of bipolar disorder and may be associated with work memory impairment.

关 键 词：双相情感障碍 磁共振成像 功能性 认知 

分 类 号：R971[医药卫生—药品]