不同症状类型首发精神分裂症患者任务态脑功能研究  

A Task-based Brain Functional Study on Different Symptom Types in First-episode Schizophrenia

作　　者：张会然 陶好娟[2] 蒲唯丹[3] 陈文[1] 刘哲宁[2] 薛志敏[2] ZHANG Hui-ran;TAO Hao-juan;PU Wei-dan;CHEN Wen;LIU Zhe-ning;XUE Zhi-min(Department of Psychiatry, The First Affiliated Hospital of Soochow University, Suzhou 215006, China;Mental Health Institute, Second Xiangya Hospital, Central South University, Changsha 410011, China;Medical Psychological Institute, Second Xiangya Hospital, Central South University, Changsha 410011, China)

机构地区：[1]苏州大学附属第一医院精神科,苏州215006 [2]中南大学湘雅二医院精神卫生研究所,长沙410011 [3]中南大学湘雅二医院医学心理学研究所,长沙410011

出　　处：《中国临床心理学杂志》2018年第3期421-426,共6页Chinese Journal of Clinical Psychology

基　　金：国家自然科学基金(81671335)

摘　　要：目的:探讨首发精神分裂症不同症状类型患者任务态下脑功能的异常。方法:52例首发精神分裂症患者,其中包括阳性症状组35例及阴性症状组17例。年龄、性别及教育程度与之相匹配的健康对照组38例。对所有参与者进行N-back任务态功能磁共振数据采集,并分析N-back任务态下三组间任务相关脑区活动差异。结果:给予N-back任务时,三组间激活差异脑区为左侧背外侧前额叶、内侧前额叶/前扣带皮质及后扣带皮质,阳性症状组及阴性症状组内侧前额叶/前扣带皮质及后扣带皮质受抑制程度低于健康对照组,阴性症状组背外侧前额叶激活显著高于阳性症状组及健康对照组。结论:结果提示左侧背外侧前额叶功能障碍在认知功能及阴性症状的病理生理过程中起重要作用,认知功能障碍可能参与阴性症状的形成;而皮质中线结构则在阳性症状(幻觉妄想)的病理生理过程中起重要作用。Objective： Our goal was to identify the possible neurobiology basis of different symptom types in schizophrenia via task-based imaging analysis. Methods： Participants were 52 first-episode schizophrenic patients comprising of positive symptom group（N=35） and negative symptom group（N=17）. A comparison group of healthy controls（N=38） were matched for age, gender and education. N-back tasking functional magnetic resonance imaging data were collected. We identified the different task-related brain activity under n-back task. Results： During N-back task paradigm, the two patient groups showed lower task-related suppression in left dorsolateral prefrontal cortex （DLPFC）/anterior cingulate cortex （ACC）, and posterior cingulate cortex（PCC） than healthy controls group; the negative symptom group showed higher task-related activation in DLPFC than the positive symptom group and healthy control group. Conclusion： The functional lesion in the left DLPFC may play an important role in the pathophysiological procedure of negative symptom and cognitive function. The left cortical midline structures may implicate in the neurobiological basis of positive symptom.

关 键 词：阴性症状 背外侧前额叶 阳性症状 皮质中线结构 

分 类 号：R395.1[哲学宗教—心理学]