精神分裂症幻听患者汉语听觉语言皮质定位的脑磁图研究

The study on the localization of the native Chinese speaker language auditory cortex using magnetoencephalography(MEG) in schizophrenic patients with auditory hallucination

目的采用脑磁图(MEG)技术探讨男性精神分裂症幻听患者汉语听觉语言皮质的定位。方法给予13例精神分裂症幻听患者和14名正常对照组双耳男、女声各100对词义相关及不相关的二个字汉语词汇刺激,并由MEG设备记录刺激后产生的听觉诱发磁场,将MEG采集数据叠加到核磁共振上获得磁源性影像。结果①患者组10例汉语听觉语言皮质定位在大脑半球双侧颞中、上回后部、额下回后部,2例在右侧额下回后部,1例在左侧颞上回后部。对照组10名定位于左侧颞中、上回后部,即Wernicke区,2名定位于右侧颞中回后部,2名定位在双侧颞上回后部。患者组定位在双侧比例明显高于对照组(76.92%vs14.29%,2=2.88,P<0.05)。②无论男声或女声刺激,患者组与对照组的中枢三维坐标在X轴上差异均有统计学意义(P<0.05)。结论精神分裂症幻听患者的汉语语言皮质定位与正常人的位置不同,更靠近颞中、上回外侧部,这一改变可能是其听觉性语言认知功能障碍的神经病理学基础之一。

Objective To localize Chinese linguistic auditory cortex in schizophrenic patients with auditory hallucination using MEG. Methods Thirteen male schizophrenic patients with auditory hallucination （study group ） and 14 healthy people （control group） were given 100 pairs of two Chinese words stimuli （containing 80 percent related words） produced by both male and female speakers. The data acquired by the MEG were superimposed on magnetic resonance imaging （MRI） to obtain magnetic source imaging （MSI）. Results （1） In study group,language auditory cortex was located in the bilateral posterior part of middle, superior temporal gyrus and inferior frontal gyrus in ten patients, in the right posterior part of inferior frontal gyrus in two patients, in the left posterior part of superior temporal gyrus in one patient. In control group, language auditory cortex was localized in the Wernicke region including the left posterior part of middle, superior temporal gyrus in ten subjects, in the right posterior part of middle temporal gyrus in two subjects, in the bilateral posterior part of the superior temporal gyrus in two subjects. The percentage of localization in bilateral cerebral hemisphere in study group （76. 92% ） were higher than that in control group （ 14. 29% ） （ P 〈 0.05 ）. （2） There were significant differences in the evoked magnetic waves induced by either male or female voice in X axis between the study and control groups （ P 〈 0. 05 ）. Conclusions The localization of Chinese linguistic auditory cortex was different between the male schizophrenic patients with auditory hallucination and normal people. The Chinese linguistic auditory cortex of schizophrenic patients is mainly located near the outer part of middle, superior temporal gyrus, which may be one of the neuro-physiopathologic mechanisms underlying auditory linguistic cognition function disorder.