不同疗效广泛性焦虑障碍患者大脑半球间功能连接差异的功能磁共振研究  

The difference of interhemispheric functional connectivity in generalized anxiety disorder with different treatment outcome:a resting-state fMRI study

作　　者：朱建英[1] 沈仲夏[1] 帅亦斌 章晓梅[1] 蔡敏[1] 任列[1] 沈鑫华[1] ZHU Jian-ying;SHEN Zhong-xia;SHUAI Yi-bin;ZHANG Xiao-mei;CAI Min;REN Lie;SHEN Xin-hua(Department of Neurosis and Psychosomatic Diseases,the Third People's Hospital of Huzhou,Huzhou 313000,China)

机构地区：[1]浙江湖州市第三人民医院心身科

出　　处：《临床精神医学杂志》2019年第3期165-170,共6页Journal of Clinical Psychiatry

基　　金：浙江省医药卫生一般项目(2015KYA213);湖州市公益性技术应用研究(2014GY16)

摘　　要：目的:探讨广泛性焦虑障碍(GAD)患者大脑半球间功能连接变化特征,以及这些变化与疗效之间的相关性。方法:使用1.5T磁共振扫描仪,比较38例经艾司西酞普兰治疗8周后的GAD患者(GAD组)及30名性别、年龄、教育程度相匹配的健康对照者(正常对照组)的基于体素镜像同伦连接(VMHC)值;同时比较痊愈患者(n=13)及非痊愈患者(n=25)VMHC值;运用DEPASF4.3AdvancedEdition软件处理数据进行全脑VMHC比较,并分析相关因素。结果:GAD患者的双侧颞中回、双侧中央前回、双侧枕中叶VMHC降低(P<0.05,Alphasim校正);GAD患者双侧小脑6区,双侧前扣带和旁扣带脑回VMHC值与基线汉密尔顿焦虑量表(HAMA)评分负相关,双侧眶内额上回VMHC值与病程负相关(P<0.05,Alphasim校正);痊愈组的双侧颞下回VMHC值显著高于非痊愈组(P<0.05,Alphasim校正)。结论:GAD患者在颞叶、额叶、部分枕叶存在双侧大脑半球间功能连接异常,两侧颞下回大脑半球间高功能连接预示艾司西酞普兰有较好的8周末疗效。Objective: To explore the characteristics of interhemispheric functional connectivity in resting-state in patients with generalized anxiety disorder(GAD) and the correlation between these changes and the outcome treated by escitalopram. Method:A 1.5 T magnetic resonance machine was used to compare the voxel mirrored homotopic connectivity(VMHC) of 38 patients with GAD and 30 healthy controls with well matched sex,age and education status,and 13 remitters and 25 non-remitters were also compared.The data were processed by DEPASF 4.3 Advanced Edition software,and the VMHC of the whole brain was compared and the relative factors were analyzed. Results:The VMHC values in middle temporal gyrus,precentral gyrus and middle occipital gyrus in GAD were significantly lower than those in healthy control(P<0.05,Alphasim correction);the VMHC values of cerebellum6 gyrus and cingulumant gyrus were negatively correlated with baseline Hamilton Anxiety Scale(HAMA) score(P<0.05,Alphasim correction) in GAD.Frontalsuporb gyrus was negatively correlated with the illness duration(P<0.05,Alphasim correction);in the remission group,the VMHC of temporalinf gyrus was higher than that in the non-remission group(P<0.05,Alphasim correction). Conclusion:The interhemispheric resting-state functional connectivity in GAD patients is abnomal in temporal lobe,frontal lobe and part of occipital lobe.The greater VMHC value in temporalinf gyrus predictes better outcome after 8 weeks of treatment by escitalopram.

关 键 词：广泛性焦虑障碍 功能连接 功能磁共振 疗效 

分 类 号：R749.7[医药卫生—神经病学与精神病学]