工作记忆相对完好精神分裂症和双相障碍患者的脑功能活动特征  

Brain activity characteristics in patients with schizophrenia and bipolar disorder with relatively intact working memory

作　　者：周丽[1] 刘哲宁[2] 吴国伟[2] 王丝丝[1] 马萍[1] 李瑽睿 潘集阳[1] ZHOU Li;LIU Zhening;WU Guowei;WANG Sisi;MA Ping;LI Congrui;PAN Jiyang(Department of Psychiatry,First Affiliated Hospital of Jinan University,Guangzhou 510630,China;Institute of Mental Health,Second Xiangya Hospital of Central South University,Changsha 410011 China)

机构地区：[1]暨南大学附属第一医院精神医学科,广州510630 [2]中南大学湘雅二医院精神卫生研究所,长沙410011

出　　处：《中国心理卫生杂志》2022年第4期287-294,共8页Chinese Mental Health Journal

基　　金：广东省医学科学技术研究基金(A2017329);暨南大学科研培育与创新基金(青年项目)(11617314);国家自然科学基金(81701325)。

摘　　要：目的:探讨工作记忆(WM)相对完好的精神分裂症(SZ)和双相障碍(BD)患者的脑功能活动特征。方法:纳入符合美国精神障碍诊断与统计手册第4版(DSM-IV)诊断标准的SZ和BD患者各45例,根据他们在功能磁共振成像(fMRI)扫描时完成WM任务表现,选取WM相对完好的18例SZ和20例BD患者,并以25例正常对照为参照,比较三组执行WM任务时全脑血氧水平依赖(BOLD)信号的活动差异。结果:与正常对照组相比,SZ患者左内侧前额叶、左后扣带回的BOLD信号显著增强(P<0.05),而BD患者左内侧前额叶、左侧壳核的BOLD信号增强(P<0.05),且其左侧壳核的BLOD信号活动与其HAMD、BPRS总分呈正相关(r=0.48、0.52,均P<0.05)。结论:工作记忆相对完好时,精神分裂症患者显示内侧前额叶、后扣带回所属的默认网络抑制活动减弱,而双相障碍患者显示由内侧前额叶、壳核所构成的皮质-纹状体通路异常活动。Objective:To explore the features of brain functional activity inpatients with schizophrenia(SZ)and bipolar disorder(BD)who with relatively intact working memory(WM)performance.Methods:Forty-five patients with SZ and BD met the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorder,Fourth Edition(DSM-IV)were enrolled respectively,then according to their WM performance during the fMRI scanning,18 patients with SZ and 20 with BD who with relatively intact WM were selected,and compared with 25 normal controls,the activity differences of blood-oxygen-level-dependent(BOLD)signal during the WM task among/between the three groups were compared Results:Compared to normal controls,with relatively intact WM performance,SZ group demonstrated the significantly increased BOLD signal in left medial prefrontal cortex(mPFC.L)and left posterior cingulate gyrus(PCG.L)(P<0.05),while BD group demonstrated that signal in mPFC.L and left putamen(PUT.L)(P<0.05),and the activity of BOLD signal in PUT.L was positively correlated with HAMD and BPRS scores(r=0.48,0.52,Ps<0.05).Conclusion:With the relatively intact working memory performance,patients with schizophrenia show the decreased suppression of default mode network consist by the mPFC and PCG,while patients with bipolar disorder show the abnormal activity of cortical-striatal pathway composed of mPFC and PUT.

关 键 词：精神分裂症 双相障碍 工作记忆 脑功能活动 

分 类 号：R749.3[医药卫生—神经病学与精神病学] R749.4[医药卫生—临床医学]