首发精神分裂症患者大脑影像与炎症因子的探究性研究  

An exploratory study on brain imaging and inflammatory cytokines in first-episode schizophrenia

作　　者：李业宁 范雅娟 马青艳[1] 周莉娜 杨再 王崴[1] 马现仓[1] 朱峰[1,3] LI Yening;FAN Yajuan;MA Qingyan;ZHOU Lina;YANG Zai;WANG Wei;MA Xiancang;ZHU Feng(Department of Mental Health,The First Affiliated Hospital of Xi'an Jiaotong University;Xi'an Jiaotong University Health Science Center;Center for Translational Medicine,The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China)

机构地区：[1]西安交通大学第一附属医院精神心理卫生科 [2]西安交通大学医学部 [3]西安交通大学第一附属医院转化医学中心,陕西西安710061

出　　处：《西安交通大学学报（医学版）》2020年第6期910-914,共5页Journal of Xi’an Jiaotong University（Medical Sciences）

基　　金：西安交通大学临床研究中心重点资助项目(No.XJTU1AF-CRF-2016-005);陕西省重点研发计划资助项目(No.2018ZDXM-SF-036)。

摘　　要：目的分析首次发作精神分裂症患者和健康对照者的功能磁共振成像(fMRI)比率低频振幅差异,并与临床症状和炎症因子相关联,进一步探索精神分裂症的发病机制。方法纳入38例首次发作精神分裂症患者(病例组)和35例正常对照者(对照组)。采集全部被试的人口学资料和脑静息态fMRI数据,并测定血清中炎症因子水平。采用阳性和阴性症状量表(PANSS)评估病例组的临床症状。采用MATLABR2014a平台及DPABI软件对fMRI数据进行预处理并计算比率低频振幅(fALFF),采用皮尔逊相关模型分析脑功能变化与临床症状和炎症因子的相关性,并采用DPABI软件、SPSS22.0软件对数据进行统计分析以及GRF(P<0.05)进行多重比较校正。结果与对照组相比,病例组的双侧壳核和右侧扣带回fALFF值明显升高,左侧楔前叶和左侧前额回fALFF值降低。病例组TNF-α、CCL2、IL-β、IL-4、IL-6以及IL-8水平高于对照组(z=-3.301,P=0.001;z=-3.053,P=0.002;z=-5.429,P<0.001;z=-6.562,P<0.001;z=-4.537,P<0.001;z=-2.153,P=0.031)。病例组双侧壳核fALFF值均与PANSS量表总分呈正相关(左侧r=0.409,P=0.025;右侧r=0.428,P=0.019)。病例组左侧楔前叶fALFF值与血清IL-4水平呈负相关(r=-0.412,P=0.026),右侧扣带回fALFF值与血清TNF-α水平呈正相关(r=0.392,P=0.035)。结论精神分裂症患者存在炎症因子和部分脑区的异常,并且双侧壳核与右侧扣带回的异常程度分别与疾病严重程度和炎症因子水平有关,提示该区域与精神分裂症的病理机制密切相关。Objective To analyze the differences in low-frequency fluctuations(fALFF) between patients with schizophrenia(SC) and healthy controls so as to further explore the pathogenesis of schizophrenia by correlating with clinical symptoms and inflammatory cytokines. Methods We recruited 38 SC patients and 35 demographically matched healthy subjects. Serum levels of inflammatory cytokines were measured by enzyme-linked immunosorbent assay(ELISA). Clinical symptoms were assessed by the Positive and Negative Symptoms Scale(PANSS). After high-resolution fMRI scanning, data processing and analysis for brain imaging(DPABI) was used to find potential differences in fALFF between the two groups. A Pearson correlation model was used to analyze the associations of functional changes with clinical symptoms and inflammatory cytokines. DPABI software and SPSS 22.0 software were used for data analysis and GRF(P<0.05) theory for multiple comparison correction. Results (1) Compared to the healthy controls,SC patients had significantly increased fALFF values in the bilateral putamen and the right cingulum,but decreased fALFF values in the left precuneus and the left superior frontal gyrus.(2) The levels of TNF-α,CCL2,IL-β,IL-4,IL-6 and IL-8 were significantly higher in SC group than in the control group(z=-3.301,P=0.001;z=-3.053,P=0.002;z=-5.429,P<0.001;z=-6.562,P<0.001;z=-4.537,P<0.001;z=-2.153,P=0.031).(3) The fALFF values of the left putamen of SC group were significantly correlated with the total scores of PANSS(Left:r=0.409,P=0.025;Right:r=0.428,P=0.019).(4) The fALFF values of the left precuneus of SC group were significantly correlated with the levels of IL-4(r=-0.412,P=0.026);the fALFF values of right cingulum of SC group were significantly correlated with the levels of TNF-α(r=0.392,P=0.035).Conclusion Abnormalities in inflammatory cytokines and partial brain regions are found in SC patients.More importantly,the left putamen and the right cingulum are associated with disease symptoms and inflammatory cytokines,suggesting tha

关 键 词：精神分裂症 比率低频振幅 炎症因子 

分 类 号：R749.3[医药卫生—神经病学与精神病学]