甲状腺功能亢进伴精神神经症状患者脑功能区研究  

Functional areas of brain in hyperparathyroidism patients with neuropsychiatric symptoms

作　　者：张利红[1] 张玲[2] 黎海涛[3] 卞士柱[4] 陈兵[1] 

机构地区：[1]内分泌科第三军医大学西南医院内分泌科,重庆400038 [2]内分泌科第三军医大学西南医院门诊部,重庆400038 [3]内分泌科第三军医大学西南医院内放射科,重庆400038 [4]第三军医大学新桥医院心血管内科,重庆400037

出　　处：《第三军医大学学报》2013年第23期2573-2576,共4页Journal of Third Military Medical University

基　　金：第三军医大学校级科研课题(SWH2012LC07)~~

摘　　要：目的研究原发性甲状腺功能亢进(甲亢)患者基础状态下自发脑功能活动特征及其与甲状腺激素、精神神经症状的相关性。方法 51例未治疗的甲亢患者为病例组,51例健康志愿者为对照组,汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD)、汉密尔顿焦虑量表(Hamilton Anxiety Scale,HAMA)评估患者抑郁焦虑程度,运用静息态功能磁共振(resting-state fMRI,rfMRI)和局部一致性(regional homogeneity,ReHo)法,分析其脑部局部一致性,并进行两组比较。结果甲亢组额上回、眶额叶和颞极ReHo值减弱;小脑蚓部ReHo值增强。小脑蚓部ReHo值与HAMA焦虑评分显著相关;额上回ReHo值在不同严重程度焦虑中差异显著,与甲状腺激素(FT3、FT4)及HAMD睡眠障碍因子显著相关;颞极ReHo值也与睡眠障碍因子相关。结论甲亢患者在静息状态下存在异常脑功能区,并与甲状腺激素、情绪障碍相关,可能是其发生精神神经症状的病理生理机制之一。Objective To investigate the characteristics of spontaneous brain functions in hyperpara- thyroidism patients with neuropsychiatric symptoms in basic state and the relationships of the characteristics with emotional disorders, spontaneous brain resting activities, biochemical and biological characteristics. Methods Fifty-one patients diagnosed with primary hyperthyroidism in our department from October 2012 to April 2013 were enrolled in this study. Another 51 age-matched healthy individuals served as control. Hamilton Depression Scale scanning （HAMD） and Hamilton Anxiety Scale （HAMA） assessment of neuropsychiatric symptoms were used to assess all subjects at the same day. A novel method based on regional homogeneity （ReHo） was used to detect unpredicted homodynamic responses across the whole brain on resting-state functional MRI （rs-fMRI） data and then to analyze the differences of ReHo between cases and control. Results Compared with control, there were 3 significantly decreased ReHo areas, including frontal gyrus, orbital frontal, and temporal pole and 1 evidently enhanced ReHo area （cerebellar vermis ）found in patients with hyperthyroidism. ReHo values in cerebellar vermis were significant different in patients with different severity of anxiety. ReHo value is closely related with F33, FT4 and sleep qualityin temporal pole. ReHo value in frontal gyrus is related with sleep disorders. Conclusion There are dysfunctional brain areas in resting state in patients with hyperthyroidism, and the abnormalities of specific eloquent areas may be the pathophysiological mechanisms for neuropsychiatric symptoms.

关 键 词：原发性甲亢 精神神经症状 静息态功能磁共振 局部一致性 

分 类 号：R581.1[医药卫生—内分泌] R749.24[医药卫生—内科学]