神经性贪食患者额叶-纹状体神经环路静息态fMRI功能连接研究  

Functional connectivity of the fronto-striatal circuitry in patients with buiimia nervosa based on resting-state fMRI

作　　者：王钰萍 张宾 黄佳滨[1] 亢清[1] 岳玲[1] 范青[1] 陈楚侨[3,4] 陈珏 肖泽萍[1] Wang Yuping;Zhang Bin;Huang Jiabin;Kang Qing;Yue Ling;Fan Qing;Chen Chuqiao;Chen Jue;Xiao Zeping(Clinical Psychology Department, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine,Shanghai 200030,China （ Wang YP,Huang JB,Kang Q,Yue L,Fan Q,Chen J,Xiao ZP;Department of EEG ＆ Neuroimaging,Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai 200030, China （ Zhang B;Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health ,Institute of Psychology, Chinese Academy of Sciences ,Beijing 100101, China （ Chen CQ;Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China （ Chen CQ)

机构地区：[1]上海交通大学医学院附属精神卫生中心临床心理科,上海200030 [2]上海交通大学医学院脑电影像室,上海200030 [3]中国科学院心理研究所心理健康院重点实验室,北京100101 [4]中国科学院大学心理系,北京100049

出　　处：《中华行为医学与脑科学杂志》2018年第4期316-321,共6页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：国家自然科学基金项目（81201055）;上海市自然科学基金项目（16ZR1430400）;上海市科委“科技创新行动计划”（16410722500）

摘　　要：目的通过fMRI技术，探讨神经性贪食（bulimia nervosa，BN）患者静息态下额叶．纹状体环路的功能连接特点及其与抑制功能的相关性。方法对27例未用药的成年女性神经性贪食患者及27名性别、年龄、受教育年限与患者组匹配的健康对照被试进行信号停止任务（stop signaltask，SST）测试；并行静息态fMRI扫描，分析比较两组纹状体功能亚区与额叶脑区间的功能连接差异。结果与对照组相比，BN组右侧腹头侧壳核（ventral rostral putamen，VRP）与右侧辅助运动区（supplementary motor areas，SMA）及运动前区（Premotorarea，PM）间的功能连接减弱（MNI坐标：x=3，Y=-15，z=51，K=27；MNI坐标：x=27，y=0，z=57，K=44）；双侧背尾侧壳核（dorsal caudal putamen，DCP）（MNI坐标：x=21，y=-6，z=48，K=43）与右侧PM（MNI坐标：x=21，y=-12，z=57，K=24）间的功能连接减弱（P〈0．05，Alphasim校正，voxel P〈0．005，体素簇≥20个体素）。BN组右侧VRP与右侧SMA的功能连接强度与停止信号反应时间（stopsignal reactiontime，SSRT）呈负相关（r=-0．595，P=0．004）；右侧DCP与右侧PM间功能连接强度与冲动性调节评分（进食障碍调查量表-Ⅱ）呈正相关（r=0．483，P=0．023）。结论未用药成年女性神经性贪食患者存在静息态下额叶运动皮层与纹状体间的功能连接异常，该功能连接异常与BN患者的抑制功能受损有关。Objective To explore the functional connectivity （FC） of the fronto-striatal circuitry in patients with bulimia nervosa （BN） based on the resting-state fMRI and its correlation with the inhibitory function. Methods 27 medication-naive female patients with BN and 27 age- and education-matched fe- male healthy control subjects were included in the study.All the subjects performed a stop signal task （SST） and underwent the resting-state fMRI scan, separately.The FC between striatal subregions and the frontal cortex was analyzed. Results Compared with healthy controls, FC between the fight ventral rostra1 putamen （ VRP ） and the fight supplementary motor areas （SMA） decreased （ MNI coordinate ： x = 3, y = - 15, z = 51, K = 27） in patients with BN.And the FC was also decreased between the right VRP and premotor area（ PM ） （ MNI coordinate ： x = 27, y = 0, z = 57, K = 44）.FC between bilateral dorsal caudal putamen （DCP） （ MNI coordinate：x=21 ,y=-6,z=48,K=43） and the right PM（MNI coordinate：x=21 ,y=-12,z=57,K=24） was decreased in patients with BN（P〈0.05, Alphasim corrected, voxel P〈O.O05, clusters I〉20 voxels）.FC between the right VRP and right SMA was negatively correlated with the stop signal reaction time （SSRT） in patients with BN （r=-0.595 ,P=0.004）.The FC between right DCP and right PM was positively correlated with the impulsivity regulation subseale scores of the Eating Disorder Inventory-Ⅱ in patients with BN（r= 0.483 ,P= 0.023）.Conelusiort There is disrupted FC between the striatum and motor cortex in medication-naive female patients with BN based on resting-state fMRl,which may be related to impaired inhibitory control in patients with BN.

关 键 词：神经性贪食 静息态功能磁共振 额叶-纹状体环路 辅助运动区 运动前区 

分 类 号：R445.2[医药卫生—影像医学与核医学] R749.7[医药卫生—诊断学]