青少年精神分裂症BOLD-fMRI特征与认知功能的关系  

Relationship between BOLD-fMRI Features and Cognitive Function in Adolescents with Schizophrenia

作　　者：吴伟斌 傅礼洪 上官文博 陈文胜[1] 黄炜[1] WU Wei-bin;FU Li-hong;SHANGGUAN Wen-bo;CHEN Wen-sheng;HUANG Wei(Department of Imaging,Foshan Third People's Hospital,Foshan 528000,Guangdong Province,China)

机构地区：[1]佛山市第三人民医院影像科,广东佛山528000

出　　处：《中国CT和MRI杂志》2022年第6期4-7,共4页Chinese Journal of CT and MRI

基　　金：佛山市科技创新项目(2020001005630)。

摘　　要：目的探究青少年精神分裂症血氧水平依赖对比成像的磁共振功能成像(BOLD-fMRI)特征与认知功能的关系。方法选取2020年4月至2021年8月在本院接受治疗的青少年精神分裂症患者50例,根据简易精神状态评价量表(MMSE)、蒙特利尔认知评估量表(MoCA)检测其认知程度,按照结果分为精神分裂症认知障碍组(SIND组)、精神分裂症认知正常组(SN组)。同时选择年龄、性别、受教育程度与精神分裂症患者相匹配的50例正常自愿者,作为对照(计为NC组)。对所有患者以及志愿者均进行BOLDfMRI检查,对比相关参数。结果50例青少年精神分裂症患者中,共有17例存在认知障碍、33例认知正常;SIND组MMSE以及MoCA评分小于SN组、NC组,SN组以上参数小于NC组(P<0.05)。三组BOLDfMRI参数γ值、λ值存在差异(P<0.05),而δ值差异无统计学意义(P>0.05);SIND组患者的γ值均小于NC组(P<0.05),SIND组λ值大于NC组志愿者,SN组λ值小于NC组(P<0.05),其余两组间同参数差异均无统计学意义(P>0.05)。SIND组患者额叶上回、脑干、海马区功能连接较SN组增强,同时右侧小脑半球皮层区、左侧顶叶皮层区功能连接较SN组减弱。结论青少年精神分裂症患者的BOLD-fMRI特征与其认知功能存在一定联系,认知障碍精神分裂症者的γ值显著降低,低于正常人群以及认知正常的精神分裂症者;λ值显著低于正常人群,但与认知正常的精神分裂症者相比差异不显著;同时存在认知障碍的患者,额叶上回、脑干、海马区功能连接增强,右侧小脑半球皮层区、左侧顶叶皮层区减弱。临床中可根据BOLD-fMRI检测结果协助诊断青少年精神分裂症者的认知功能,从而制定治疗方案。Objective The aim of this study was to explore the relationship between blood oxygenation level dependent functional magnetic resonance imaging(BOLD-fMRI)features and cognitive function in adolescents with schizophrenia.Methods Fifty adolescents with schizophrenia treated in the hospital were selected between April 2020 and August 2021.The Mini-Mental State Examination(MMSE)and Montreal Cognitive Assessment Scale(MoCA)were used to evaluate cognition degree.According to the assessment results,the subjects were divided into schizophrenia with cognitive impairment group(SIND group)and schizophrenia with normal cognition group(SN group).Meanwhile,50 normal volunteers of matching age,gender,and education level were selected as controls(NC group).Both groups were subjected to BOLD-fMRI examinations,and relevant parameters were compared.Results Among the 50 adolescents with schizophrenia,there were 17 adolescents with cognitive impairment and 33 adolescents with normal cognition.The MMSE scores and MoCA scores of the SIND group,SN group,and NC group increased in order(P<0.05).BOLD-fMRIγvalue andλvalue were different in the three groups(P<0.05),but there was no statistically significant difference inδvalue(P>0.05).Theγvalue of SIND group was lower than that of NC group(P<0.05),theλvalue of SIND group was higher than that of NC group,andλvalue of SN group was lower than that of NC group(P<0.05).There was no significant difference in these parameters between the other two groups(P>0.05).The functional connectivity of upper frontal gyrus,brainstem,and hippocampal region in SIND group was stronger than that in SN group.Meanwhile,the functional connectivity of right cerebellar hemisphere and left parietal cortex was weaker than that in SN group.Conclusion BOLD-fMRI features are related to cognitive function in adolescents with schizophrenia,andγvalue is significantly lower in schizophrenia patients with cognitive impairment than in normal people and schizophrenia patients with normal cognition.λvalue is significantly

关 键 词：青少年精神分裂症 磁共振功能成像 认知功能 功能连接 

分 类 号：R749.3[医药卫生—神经病学与精神病学]