静息状态下精神分裂症与双相障碍患者脑功能磁共振低频振幅的比较研究

Comparison of Amplitude of Low Frequency Fluctuation between Schizophrenia and Bipolar Disorder Patients:a Resting-state Functional Magnetic Resonance Imaging Study

目的比较精神分裂症患者与双相障碍患者的静息态脑功能磁共振低频振幅的异同,为这2种疾病的诊断及鉴别诊断提供理论依据。方法对40例精神分裂症患者、40例双相障碍患者以及年龄、性别、教育年限相匹配的40例健康者(健康组)进行静息态脑功能磁共振扫描,并对3组受试者的低频振幅值进行两两比较。结果与健康组相比,精神分裂症患者与双相障碍患者在前额叶、眶额叶、边缘系统、基底节的低频振幅值均显著升高,在岛叶、默认网络、部分枕叶及感觉运动区的低频振幅值均显著降低,且精神分裂症患者和双相障碍患者在以上脑区的低频振幅无显著差异。精神分裂症患者在颞叶的低频振幅显著高于双相障碍患者和健康组,且双相障碍患者和健康组在以上脑区的低频振幅无显著差异。结论发现精神分裂症患者和双相障碍患者在前额叶、眶额叶、边缘系统、基底节、默认网络、部分枕叶及感觉运动区共有的低频振幅值增高或减低,提示这2种疾病可能存在相似的发病机制,而仅在精神分裂症患者出现的颞叶低频振幅改变可能为鉴别这2种疾病提供研究基础。

Objective To explore possible pathophysiology of schizophrenia and bipolar disorder, so as to lay foundation of differentiation and di- agnosis of the two diseases. Methods Amplitude of low frequency fluctuation （ALFF） of 40 schizophrenia patients, 40 bipolar disorder patients and 40 healthy controls in resting state were recorded and compared. Results Compared to healthy controls, schizophrenia and bipolar disorder groups both showed significant increased ALFF in prefrontal, orhitofrontal cortex, limbic, basal ganglia, and decreased ALFF in default mode, oc- cipital cortex and sensorimotor areas. There was no significant difference between schizophrenia and bipolar disorder. Compared to bipolar disorder patients and healthy controls, schizophrenia showed significant increased ALFF in temporal, and there was no significance between bipolar disorder and healthy controls. Conclusion The common increased or decreased ALFF in schizophrenia and bipolar disorder in prefrontal, orbitofrontal cor- tex, limbic, basal ganglia, default mode network, occipital cortex and sensorimotor areas may imply the similar pathophysiology behind the similar clinical manifestations. The distinct altered ALFF in schizophrenia in the temporal lobe may lay a foundation for distinguishing of the two diseases.