首发精神分裂症幻听静息态脑功能连接的研究  

Altered Resting-state Functional Connectivity of Auditory Verbal Hallucinations in First-episode Schizophrenia

作　　者：陈旭东 薛志敏[1] 刘哲宁[1] 彭程 CHEN Xu-dong;XUE Zhi-min;LIU Zhe-ning;PENG Cheng(Mental Health Institute of Central South University,Changsha 410011,China;Department of Scientific Research of Central South University,Changsha 410012,China)

机构地区：[1]中南大学精神卫生研究所,长沙410011 [2]中南大学科学研究部,长沙410012

出　　处：《中国临床心理学杂志》2019年第6期1073-1080,共8页Chinese Journal of Clinical Psychology

基　　金：国家自然科学面上基金(项目编号：81671335);国家自然科学基金国际(地区)合作与交流项目(项目编号：81561168021);精准医学研究项目(项目编号：2016YFC0906300)

摘　　要：目的:对首发精神分裂症幻听患者、非幻听患者以及正常对照的静息态功能核磁共振数据进行研究,探索首发精神分裂症幻听患者功能连接的异常模式。方法:本研究根据DSM-Ⅳ精神分裂症诊断标准,入组首发精神分裂症持续性幻听患者37例、首发精神分裂症非幻听患者59例及健康对照64例。对所有被试进行临床评估和静息态功能磁共振扫描,以初级听觉皮层和次级听觉皮层脑区为种子点构建全脑功能连接图,比较分析三组的连接差异。结果:首发精神分裂症幻听患者相对正常对照在左侧颞上回与对侧的岛叶、同侧内侧前额叶功能连接下降,左侧Heschl回(Heschl’s gyrus,HG)与对侧颞下回、同侧内侧前额叶功能连接下降,右侧HG与左侧的颞中回功能连接下降。首发精神分裂症非幻听患者虽与幻听患者并未发现功能连接显著差异,但相对于幻听组,非幻听患者组在更广泛的脑区出现了功能连接下降。结论:精神分裂症在疾病的早期阶段就出现了大脑不同脑区内的连接异常,尤其是双侧大脑间的"失连接"异常模式,进一步揭示了精神分裂症大脑整合功能的异常。Objective: To investigate the abnormal resting-state functional connection mode of first-episode schizophrenia with persistent auditory verbal hallucinations(AVH) compared with schizophrenia without AVH and healthy controls.Methods: 37 patients with first-episode schizophrenia persistent AVH, 59 first-episode schizophrenia without AVH and 64 healthy controls according to the DSM-Ⅳ diagnostic criteria were recruited. Clinical assessment and resting-state functional magnetic resonance imaging scans of all participants were collected. The primary auditory cortex and secondary auditory cortex brain as regions of interest were used to build whole brain function connection diagram, then three groups of connection were compared. Results: The first-episode schizophrenia with AVH showed decreased functional connectivity on the left superior temporal gyrus with right insula, left medial prefrontal cortex, the left Heschl’s gyrus with right temporal gyrus, medial prefrontal, the right Heschl’s gyrus with left temporal relative to healthy controls. There is no difference between first-episode schizophrenia patients with AVH and patients without AVH. In addition, relative to the AVH group, patients with AVH showed decreased functional connectivity among broader brain regions. Conclusion: The altered connection patterns particularly"disconnection"bilateral cerebral hemispheres were observed in the early stages of schizophrenia,which reveals the altered brain functional integrity in schizophrenia.

关 键 词：精神分裂症 幻听 功能连接 首发 

分 类 号：R395.1[哲学宗教—心理学]