惊恐障碍患者默认网络的改变  

Change of Default Mode Network in Patients with Panic Disorders

作　　者：汤伟军[1] 林国珍[2] 诸索宇[3,4] 王志阳[3,4] 施慎逊[3,4] 邵春红[3] 

机构地区：[1]复旦大学附属华山医院放射科 [2]交通大学附属瑞金医院临床心理科 [3]复旦大学附属华山医院精神医学科 [4]交通大学附属上海市精神卫生中心

出　　处：《中国医学计算机成像杂志》2016年第4期307-312,共6页Chinese Computed Medical Imaging

基　　金：上海市卫生局课题No.20114358;国家自然科学基金青年基金No.81201033;复旦大学人才培养项目No.JJF151057~~

摘　　要：目的:从脑网络的角度,研究惊恐障碍患者默认模式网络的变化,为探讨惊恐障碍的神经生物学机制提供可能的理论信息。方法:被试者包括20名首发、未用药的惊恐障碍患者(PD组)和19名健康对照者(HC组)。其中,惊恐障碍患者来自复旦大学附属华山医院心理咨询门诊和上海交通大学医学院附属瑞金医院临床心理科门诊,健康对照者来自华山医院体检中心。所有被试者完成一般人口学资料收集和焦虑评估后,进行功能磁共振扫描获取静息态磁共振数据。一般人口学资料及情绪量表数据采用SPSS 16.0软件进行统计学分析,f MRI数据使用SPM8软件进行分析。结果:全部患者组和对照组被试者均完成一般人口学资料采集和情绪量表评估。由于头动,患者组3例和对照组2例的功能磁共振数据被剔除。两组被试者的年龄、受教育年限及性别构成比差异,均未见统计学意义(P>0.05);与HC组相比,PD组患者的焦虑量表和抑郁量表的评分明显高于HC组(t=29.95,P=0.000;t=9.037,P=0.000)。静息态功能磁共振结果显示,与HC组相比,PD组患者默认模式网络中的前扣带回(ACC)与左侧楔前叶、左侧角回和左内侧额叶后部皮质之间的功能连接增高,ACC与左侧眶中回的功能连接减弱。结论:惊恐障碍改变了默认模式网络(DMN)的功能连接,可能因此促进惊恐障碍患者恐惧环路的形成。Purpose： To explored the changes of default mode network in patients with panic disorder（PD） and tried to provide more information for identifying the neuro-biological mechanism for panic disorder. Methods： Twenty patients with panic disorder（PD group） and 19 age and gender matched health controls（HC group） were recruited. All patients were from the out-patient departments of psychiatry department in Huashan hospital of Fudan university and of clinical psychiatry department in Ruijin hospital affiliated to Jiaotong university. HC group was from the physical examination department of Huashan hospital. All participants were screened by mini international neuropsychiatric disease interview（MINI）. Patients who met DSM-IV diagnostic criteria for PD without comorbidity, aged 18-45 years old, first episode, drug naive were enrolled. All participants were evaluated with Hamilton anxiety rating scale（HAMA） and Hamilton depression rating scale（HAMD）.The above assessment and evaluation were implemented by two professional psychiatrists. After completion of MRI scans for all subjects, the unqualified data due to head movement and other factors were excluded. SPSS16.0 was used to analyze the demographic data and emotional evaluation. Seedbased functional connectivity analyses of anterior cingulate cortex（ACC） were processed by SPM8. Results： All participants finished the emotional evaluation. The functional data of 3 participants were moved out of the analysis due to head movement. The result demonstrated that the total scores of HAMA and HAMD were much higher in PD group than that in HC group（t=29.95, P=0.000; t=9.037,P=0.000 respectively）. There was no statistical difference in age, gender and education between these two groups（P〉0.05）. The functional connectivity was strengthened between ACC and left precuneus, left angular gyrus and left posterior medial frontal cortex. The result also demonstrated that the functional connectivity was weaker between ACC and left middle orbital g

关 键 词：惊恐障碍 静息态 功能磁共振 默认模式网络 功能连接 

分 类 号：R445.2[医药卫生—影像医学与核医学]