首发精神分裂症患者服用利培酮治疗后静息态脑功能的研究  

Study on resting-state brain function in patients with first-episode schizophrenia after risperidone treatment

作　　者：李日鹏[1] 邹文锦[1] 陆小兵[1] 宁玉萍[1] Li Ripeng;Zou Wenjin;Lu Xiaobing;Ning Yuping(The Affiliated Brain Hospital of Guangzhou Medical University,Guangzhou 510250,Guangdong,China)

机构地区：[1]广州医科大学附属脑科医院,广东广州510250

出　　处：《临床心身疾病杂志》2024年第1期20-24,共5页Journal of Clinical Psychosomatic Diseases

基　　金：广州市医药卫生科技项目西医一般引导项目(编号20181A011043)。

摘　　要：目的首发精神分裂症患者服用探讨利培酮治疗前后,静息态脑功能局部一致性变化特点以及与临床症状的关系。方法对30例首发精神分裂症患者(观察组)和30名健康志愿者(对照组)进行静息态脑功能磁共振成像扫描,计算全脑局部一致性的ReHo值并进行比较;治疗前与治疗8周后采用阳性与阴性症状量表(PANSS)和Hoffman幻听评定量表(AHRS)对患者进行临床评定;将患者治疗前后的精神症状量表评分与异常脑区的ReHo值进行相关性分析。结果治疗后,观察组患者PANSS总分及各维度评分、AHRS评分均较治疗前降低(P<0.01)。与对照组志愿者相比,治疗前观察组患者ReHo值降低的脑区主要分布于左颞上回、左颞下回,ReHo值升高的脑区主要分布于双楔前叶、右顶上小叶、右小脑后叶(已校正,P<0.05);治疗后观察组患者ReHo值升高的脑区主要分布于右小脑前叶、右顶上小叶,ReHo值降低的脑区位于左颞下回(已校正,P<0.05)。观察组患者治疗前左颞上回ReHo值与PANSS阳性症状评分和AHRS评分均呈显著负相关(r=-0.433、-0.238,P<0.05)。结论精神分裂症患者的多个脑区存在静息态脑功能异常,左颞上回异常的脑活动与疾病症状有关。Objective To explore the character ist ics of regional-homogeneity(Reho)changes of resting-state brain function before and after risperidone treatment and their relationship with clinical symptoms in patients with first-episode schizophrenia(FES).Methods Resting-state functional magnetic resonance imagings(rs-fMRI)were conducted in thirty FES patients(observation group)and 30 healthy volunteers(cont rol group),whole-brain Reho values calculated and compared;clinical assessments were conducted using the Positive and Negative Syndrome Scale(PANSS)and the Hoffman's Auditory Hallucination Rating Scale(AHRS)before treatment and in the 8th week after treatment;cor relation analyses were conducted between pre-and post-t reatment scores on psychiatric symptom scale and Reho values of abnormal brain regions.Results After treatment the total and each dimension score of the PANSS as well as the AHRS score lowered compared with pretreatment in observation group(P<0.01).Before treatment brain regions with lowered ReHo values mainly distributed in left superior temporal gyrus and left inferior temporal gyrus as well as those with elevated ReHo values did in bilateral precuneus,right superior lobule,and right lateral cerebellar lobe in observation group compared with the volunteers(cor rected,P<0.05).Post-treatment ReHo value of the left superior temporal gyrus was negatively correlated with the PANSS positive score and the AHRS score(r=-0.433,-0.238;P<0.05)。Conclusion Resting-statebra in dysfunct ions are in many brain regions in schizophrenics,abnormal brain activities of left superior temporal gyrus are related to the disease symptoms.

关 键 词：首发精神分裂症 利培酮 静息态脑功能磁共振成像 局部一致性 

分 类 号：R749.3[医药卫生—神经病学与精神病学]