以阳性症状为主的首发未治疗精神分裂症患者脑白质网络拓扑特征  

Topological characteristics of brain white matter network in first-episode untreated schizophrenics with positive symptoms

作　　者：姚丽敏 肖华 孙晓宇[2] YAO Limin;XIAO Hua;SUN Xiaoyu(Nanjing Jiangning District Second People’s Hospital,Nanjing 211103,China)

机构地区：[1]南京市江宁区第二人民医院,江苏南京211103 [2]苏州市广济医院

出　　处：《精神医学杂志》2022年第3期283-287,共5页Journal of Psychiatry

基　　金：苏州市临床重点病种诊疗技术专项(编号:LCZX201919)。

摘　　要：目的探索以阳性症状为主的首发未治疗精神分裂症患者大脑白质网络中皮层与皮层下区域局部与全局效率的变化情况,以分析与疾病发生相关的中枢性病理机制。方法选取以阳性症状为主的首发未治疗精神分裂症患者(研究组)25例和健康对照者(对照组)30名,采用阳性和阴性症状量表(PANSS)评估患者的临床症状。采集所有被试的大脑核磁共振成像(MRI)数据,包括T1结构数据及弥散张量成像(DTI)数据。基于PANDA工具对MRI数据进行预处理,构建脑白质网络,计算脑网络中各脑区的局部与全局效率属性值。使用独立双样本t检验比较组间各指标的差异,通过FDR方法对差异进行多重比较校正;同时分析各差异指标区分精神分裂症与健康对照者的特异性和敏感性,并绘制受试者工作特征曲线(ROC),根据曲线下面积(AUC)评价其诊断效能。结果研究组右侧背外侧额上回、右侧内侧额上回、右侧杏仁核以及左侧颞中回颞极局部效率属性值较对照组下降(P<0.05),差异均未通过FDR校正;研究组右侧苍白球、右侧颞横回以及双侧丘脑全局效率属性值较对照组下降(P<0.05),其中右侧苍白球与左侧丘脑差异均通过FDR校正。右侧苍白球ROC曲线下面积为0.76(P=0.00098,敏感度=56%,特异度=97%,95%CI:0.62~0.90),左侧丘脑ROC曲线下面积为0.78(P=0.00039,敏感度=60%,特异度=93%,95%CI:0.65~0.91)。结论右侧苍白球与左侧丘脑在脑白质网络中信息整合效率的下降可能是阳性症状为主精神分裂症发病的中枢性病理机制。Objective To explore the changes of local and global efficiencies of cortical and subcortical regions in the brain white matter network of first-episode untreated schizophrenics with positive symptoms and to analyze the central pathological mechanism related to the occurrence of schizophrenia.Methods 25 first-episode untreated schizophrenics with positive symptoms in study group and 30 healthy controls in control group were selected and the study group was assessed with Positive and Negative Syndrome Scale(PANSS).The brain magnetic resonance imaging(MRI)data of all subjects including T1 data and diffusion tensor imaging(DTI)data were collected.MRI data were preprocessed through PANDA.In addition,the brain white matter networks were constructed,and the local and global efficiencies of each region in the brain network were calculated.The differences of indexes between groups were compared by the independent two sample t-test,and the differences were corrected by FDR.Moreover,the specificity and sensitivity of abnormal indexes to distinguish schizophrenia from healthy controls were calculated.The receiver operating characteristic curve(ROC)of each index was computed,and its diagnostic efficacy was evaluated according to the area under the curve(AUC).Results The local efficiencies of right dorsolateral superior frontal gyrus,medial superior frontal gyrus,amygdala and left middle temporal gyrus in study group were lower than those in control group(P<0.05);however,the differences did not survive the correction of FDR.The global efficiencies of right pallidus,heschl gyrus and bilateral thalamus in study group were lower than those in control group(P<0.05);the differences of right pallidus and left thalamus survived the correction of FDR.The AUC of right pallidus was 0.76(P=0.00098,sensitivity=56%,specificity=97%,95%CI:0.62~0.90),and the AUC of left thalamus was 0.78(P=0.00039,sensitivity=60%,specificity=93%,95%CI:0.65~0.91).Conclusion The decreased information integration efficiency of right pallidus and left thalamus i

关 键 词：精神分裂症 弥散张量成像 脑网络 丘脑 苍白球 

分 类 号：R749.3[医药卫生—神经病学与精神病学]