精神分裂症幻听的静息态脑网络研究  

Dysconnectivity of multiple resting-state networks in patients with schizophrenia with auditory verbal hallucinations

作　　者：廖金敏[1] 刘琦[1] 姜思思[1] 张晓[1] 董铮[1] 蔡丽伟[1] 闫俊[1] 张岱[1] 阎浩[1] LIAO Jin-Min LIU Qi JIANG Si-Si ZHANG Xiao DONG Zheng CAI Li-Wei YAN Jun ZHANG Dai YAN Hao(Peking University Sixth Hospital, Peking University Institute of Mental Health, Key Laboratory for Mental Health, Ministry of Health （Peking University）, National Clinical Research Center for Mental Disorders, Beijing 100191, China)

机构地区：[1]北京大学第六医院北京大学精神卫生研究所卫生部精神卫生学重点实验室(北京大学)国家精神心理疾病临床医学研究中心,北京100191

出　　处：《中国心理卫生杂志》2017年第5期337-344,共8页Chinese Mental Health Journal

基　　金：国家科技支撑计划"基于临床医学研究协同网络的情感认知障碍综合诊疗关键技术研究"(2015BAI13B01);科技部国家"973"计划项目子课题"弥漫性脑损害(精神分裂症)的脑网络研究"(2011CB707805)

摘　　要：目的:使用独立成分分析法(ICA)研究精神分裂症幻听相关的脑网络特征性表现。方法:选取符合精神障碍诊断与统计手册第四修订版(DSM-IV-TR)精神分裂症的诊断标准患者,30例伴频繁幻听(AVH),24例不伴幻听(non-AVH),以及年龄、性别匹配的60例正常对照(HC)纳入统计分析。采用Hoffman幻听量表评估幻听的严重程度。采集所有受试者静息态的脑功能磁共振成像数据,利用ICA方法提取听觉网络、语言网络、突显网络、右额顶网络及默认网络,采用协方差分析比较三组受试者脑区活动在上述各网络内部的差异及网络间连接强度的差异,进一步评估AVH与non-AVH组间差异与幻听严重程度的关系。结果:与non-AVH组相比,AVH组听觉网络中的左侧颞上回和左侧中央后回的活动增强(P<0.05,FDR校正),左侧颞上回脑区活动强度与幻听严重程度呈正相关(r=0.43,P<0.05);AVH组突显网络中的右侧前扣带回的活动减弱(P<0.05,FDR校正),且与幻听严重程度呈负相关(r=-0.48,P<0.01)。网络间连接强度分析显示,与non-AVH组相比,AVH组语言网络-听觉网络连接强度减弱[(-0.29±0.21)vs.(-0.16±0.17),P<0.05,未校正],突显网络-语言网络连接强度减弱[(-0.09±0.22)vs.(-0.06±0.18),P<0.05,未校正],突显网络-听觉网络连接强度增强[(0.30±0.18)vs.(0.15±0.24),P<0.05,未校正]。结论:本研究显示伴频繁幻听的精神分裂症患者听觉网络、语言网络及突显网络存在异常,提示精神分裂症患者幻听的产生可能和语言的产生、语音的感知及自我识别有关。Objective： To explore the traits of functional connectivity of resting-state networks in patients of schizophrenia with auditory verbal hallucinations （AVH） by using independent component analysis （ICA）. Meth- ods： All patients were met the Diagnostic and Statistical Mannal of Mental Disorders, Fourth Edition, Text Revision （DSM-IV-TR） diagnostic criteria for schizophrenia. Thirty schizophrenia patients with frequent AVH （AVH）, 24 schizophrenia patients without AVH （non-AVH） and 60 healthy controls （HC） matching with age and gender wereanalyzed by resting functional magnetic resonance imaging. The AVH were assessed by using Hoffman auditory hal- lucination scale. By using ICA, auditory network （AUN）, language network （LAN）, salience network （SAN）, right front-parietal network （RFP） and default mode network （DMN） were selected as interesting networks for further analyses. Covariance analysis was used to compare the activity and functional connectivity of multiple resting state networks between three groups, and correlation analysis was used to evaluate the relations between abnormalities of brain and the severity of hallucination. Results： Compared to non-AVH, AVH group showed increased activity in left superior temporal gyms （STG） and left postcentral gyms （LPG） in the AUN, and showed decreased activity in right anterior cingulate cortex （ACC） in the SAN （P 〈 0. 05, FDR corrected）. The severity of AVH group was as- sociated with activity of the left STG （r =0. 43, P 〈0. 05） and the right ACC （r = -0.48, P 〈0.01）. Furthermore, compared to non-AVH group, there were decreased connectivity between LAN and AUN [ （ - 0. 29 ± 0. 21） vs. （ - 0. 16±0. 17）, P 〈0. 05, uncorrected], decreased connectivity between SAN and LAIN [ （ - 0. 09± 0. 22） vs. （ - 0.06 ＋0. 18）, P 〈0. 05, uncorrected], increased connectivity between SAN and AUN [（0. 30 ±0. 18） vs. （0. 15± 0. 24）, P 〈 0. 05, uncorrected] in AVId group. Con

关 键 词：精神分裂症 幻听 静息态脑网络 独立成分分析 功能磁共振成像 

分 类 号：R749.3[医药卫生—神经病学与精神病学] R445[医药卫生—临床医学]