创伤后应激障碍患者静息态下脑功能局部一致性的研究

A Study of Resting State Functional Magnetic Resonance Imaging in Patients with Posttraumatic Stress Disorder Using Regional Homogeneity

目的利用局部一致性(ReHo)方法探测创伤后应激障碍(PTSD)患者在静息状态下是否存在着大脑功能异常。方法 2010年5月-7月对18例未经治疗的地震PTSD患者和19例同样经历地震但未患PTSD的对照者进行了静息态功能磁共振成像(Rs-fMRI)扫描。应用ReHo方法处理Rs-fMRI数据,得出PTSD患者的异常脑区,并将患者存在组间差异的脑区ReHo值与临床用PTSD诊断量表(CAPS)、汉密尔顿抑郁量表(HAMD)和汉密尔顿焦虑量表(HAMA)分别进行相关分析。结果①PTSD组ReHo显著增加的脑区包括右侧颞下回、楔前叶、顶下叶、中扣带回,左侧枕中回以及左/右侧后扣带回;ReHo显著降低的脑区包括左侧海马和左/右侧腹侧前扣带回。②异常脑区中后扣带回和右侧中扣带回ReHo与HAMD呈负相关(中扣带回r=0.575,P=0.012;右侧后扣带回:r=0.507,P=0.032),其余脑区ReHo与临床指标无明显相关性(P>0.05),左侧海马与CAPS的相关性相对其他脑区较大(r=0.430,P=0.075)。结论 PTSD患者在静息状态下即存在着局部脑功能活动的降低和增加,ReHo方法可能有助于研究PTSD患者静息状态脑活动。

Objective To assess the alterations of brain resting-state functions in patients with posttraumatic stress disorder（PTSD） with the method of regional homogeneity（ReHo）.Methods Eighteen PTSD patients and 19 controls who experienced the earthquake were imaged with resting-state fMRI（Rs-fMRI） between May and July 2010.The Rs-fMRI data were analyzed with the ReHo method to define the abnormal brain regions of PTSD patients.The ReHo values of different regions concerned between the two groups were correlated with clinician administered post traumatic stress disorder scale（CAPS）,Hamilton Rating Scale for Depression（HAMD）,and Hamilton Rating Scale for Anxiety（HAMA）.Results Compared with healthy controls,increased ReHo was found in PTSD patients in the right inferior frontal gyrus,precuneus, inferior parietal lobule,middle cingulate cortex,left middle occipital gyrus and bilateral posterior cingutate;and decreased ReHo was found in ventral anterior cingutate and left hippocampus.The ReHo of abnormal brain regions in middle cingulate cortex and right posterior cingutate were negatively correlated with HAMD（middle cingulate cortex,r= 0.575,P=0.012; right posterior cingutate,r= 0.507,P=0.032）,while others did not have any significant differences（P 0.05）.ReHo of left hippocampus was associated to a greater extent with CAPS scores,though this correlation was not statistically different（r= 0.430,P=0.075）.Conclusions Abnormal local brain activity might exist in PTSD patients during resting state.The ReHo may be potentially helpful in exploring resting state brain activity of PTSD patients.