偏执型精神分裂症患者Stroop操作的功能磁共振研究

Brain dysfunctioning during attention task in patients with schizophrenia:a functional magnetic resonance imaging study

目的利用功能磁共振显像(fMRI)技术探讨精神分裂症患者注意障碍的脑功能基础。方法对14例精神分裂症患者(患者组)和16名正常人(对照组)检测Stroop测验刺激下的fMRI。结果(1)激活脑区计数(个)：Stroopl刺激下,患者组左侧额下回(11/3)、左侧颞上回(6/8)、左侧颞下回(6/8)脑区激活计数均多于对照组(分别为6/10、1/15、1/15),差异有统计学意义(P＜0.05)；Stroop2刺激下,患者组左侧前扣带皮质(ACC,4/10)、右侧额中回脑区激活计数(4/10)均少于对照组(分别为12/4、14/2),差异有统计学意义(P＜0.05),患者组左额上回激活计数(9/5)多于对照组(3/ 13),差异有统计学意义(P＜0.05)。(2)激活脑区体积(体素)：Stroop1刺激下,患者组右侧前额叶背外侧区(DLPFC,256±579)、左侧ACC(18±59)激活体积小于对照组(分别为298±597、67±87),差异有统计学意义(P＜0.05)；Stroop2刺激下,患者组两侧DLPFC(分别为73±190、80±245)、左侧ACC(17±28)激活体积小于对照组(分别为425±800、414±703、76±98),差异有统计学意义(P＜0.05)。结论精神分裂症患者的注意障碍可能与前额叶、ACC、颞叶神经回路功能障碍密切相关。

Objective To investigate brain functioning during attention task in patients with schizophrenia by using functional magnetic resonance imaging. Methods Fourteen paranoid schizophrenic patients and sixteen healthy volunteers underwent fMRI when performing Stroop test. Results （ 1 ） Left inferior frontal, left superior temporal and inferior temporal gyrus was activated significantly in patients （ the activated number was 11/3, 6/8, 6/8 respectively） than that in controls （the activated number was 6/10, 1/15, 1/15 respectively） during Stroop1 test （P 〈 0. 05）. Right middle frontal, left anterior cingulate gyrus （ACC） in schizophrenic patients （both activated number was 4/10 ） was activated poorly than that in controls （the activated number was 12/4, 14/2 respectively） during Stroop2 test （ P 〈 0. 05 ）. However, left superior frontal gyrus of patients （ the activated number was 9/5 ） was activated significantly than that of controls （the activated number was 3/13） during Stroop2 test （P 〈0. 05 ）. （2） Activation volume of right DLPFC, left ACC was significantly less during Stroop1 test in patients （ the activated volume was 256 ± 579, 18 ± 59 respectively） than that of controls （the activated volume was 298 ± 597, 67 ± 87 respectively） （P 〈 0. 05）. Activation volume of bilateral DLPFC, left ACC during Stroop2 test was less in patients （the activated volume was 73 ± 190, 80 ±245, 17 ±28 respectively） than that in controls （ the activated volume was 425 ± 800, 414 ± 703, 76 ± 98 respectively） （ P 〈 0. 05 ）. Conclusion The findings of dysfunction in prefrontal lobe, left ACC and temporal lobe in schizophrenia give further support that these dysfunction brain areas （circuits） may be related to schizophrenic patients＇ attention deficit.