难治性精神分裂症患者低频振幅的静息态功能脑影像特点

杨艳 薛丰丰

[摘要] 目的 分析难治性精神分裂症患者和健康被试者在静息状态下脑功能差异，探索精神分裂症脑功能损害的相应脑区。 方法 选取2017年12月至2020年12月杭州市第七人民医院收治的难治性精神分裂症患者32例，通过宣传的方式在杭州市招募健康被试者27例。按照有无精神分裂症分为难治性精神分裂症组和健康对照组。难治性精神分裂症组最终纳入28例，健康对照组27例。对所有研究对象进行静息状态功能磁共振（fMRI）扫描，采用低频振幅（ALFF）的方法比较两组间的差异脑区。 结果 难治性精神分裂症患者组较健康对照组在左侧颞中回、右侧角回、右侧枕中回及左侧枕中ALFF值升高（P<0.05）;在右侧舌回及左侧楔前叶ALFF值降低（P<0.05）。 结论 难治性精神分裂症组患者较健康对照组在静息状态差异脑区出现在颞叶、枕叶及楔前叶等多个脑区，并且存在“默认网络”功能活动异常。

[关键词] 精神分裂症;静息态;功能磁共振;低频振幅

[中图分类号] R749.3          [文献标识码] B          [文章编号] 1673-9701（2021）30-0115-04

[Abstract] Objective To analyze the differences in brain function between patients with refractory schizophrenia and healthy subjects at rest and explore the corresponding brain regions of brain function impairment in schizophrenia. Methods A total of 32 patients with refractory schizophrenia admitted to the Hangzhou Seventh People's Hospital from December 2017 to December 2020 were selected，and 27 healthy subjects were recruited in Hangzhou by publicity.They were divided into the refractory schizophrenia group and the healthy control group according to the presence or absence of schizophrenia.Twenty-eight cases were finally included in the refractory schizophrenia group and 27 cases in the healthy control group. Resting-state functional magnetic resonance imaging（fMRI） scans were performed on all study subjects.The differential brain regions between the two groups were compared using the amplitude of low-frequency fluctuation（ALFF）. Results Compared with the healthy control group， the ALFF values of the left middle temporal gyrus，right angular gyrus， right middle occipital gyrus，and left occipital gyrus in the refractory schizophrenia group were increased（P<0.05），and the ALFF values of the right lingual gyrus and left precuneus in the refractory schizophrenia group were decreased（P<0.05）. Conclusion Compared with the healthy control group，the refractory schizophrenia group has different resting-state brain regions in the temporal lobe，occipital lobe， and precuneus lobe，and has abnormal functions of the "default network".

[Key words] Schizophrenia; Resting-state; Functional magnetic resonance; Amplitude of low-frequency fluctuation

精神分裂癥是精神科常见的重性精神疾病，多为慢性病程，临床症状复杂，常致使患者社会功能严重受损，随病程迁延容易走向衰退。国内流行病学研究显示精神分裂症患病率达1%左右，最终发展为难治性精神分裂症的概率为23%～58%[1]。近20年来磁共振成像技术（Functional magnetic resonance imaging，fMRI）发展迅速，通过fMRI分析脑组织中血氧水平变化反应神经活动的强度现已成可能。在静息态脑功能磁共振研究方法中，低频振幅（Amplitude of low-frequency fluctuation，ALFF）通过测量体素在0.01～0.08 Hz BOLD信号波动的能量反应局部脑区自发性脑功能活动[2]。……