缺陷型精神分裂症患者后扣带回功能连接的静息态功能磁共振成像研究

Posterior cingulated cortex functional connectivity in deficit schizophrenia： a resting state functional magnetic resonance imaging study

目的探讨缺陷型精神分裂症患者后扣带回相关的静息脑功能连接网络与对照的差异。方法选取年龄、教育程度相匹配的缺陷型精神分裂症患者（缺陷组）、非缺陷型精神分裂症患者（非缺陷组）、健康志愿者（对照组）各30例男性，进行静息态蹦砌扫描，以后扣带回为种子点，与全脑其他区域进行基于体素相关分析，比较3组间后扣带回功能连接网络变化。结果排除头动因素后，缺陷组27例、非缺陷组26例、对照组25名纳入分析：（1）缺陷组阴性症状量表总分（26．7±2．4）分、缺陷型精神分裂症诊断量表阴性症状分（11．2±2．7）分，均较非缺陷组高[分别为（14．3±1．2）分，（4．1±2．6）分]，差异有统计学意义（t值分别为23．667、9．812，P〈0．01）。（2）3组间后扣带回功能连接网络差异有统计学意义的脑区集中于左、右侧额中回，左、右侧额上回，左侧额下回，左、右侧小脑，左、右侧小脑后叶，左侧颞下回，右侧颞中回，左侧尾状核，左、右侧边缘叶（海马旁回），左侧楔叶，左、右侧楔前叶。（3）缺陷组与对照组比较，后扣带回功能连接减弱的脑区有：左、右侧额中回（背外侧），左、右侧小脑，左侧边缘叶，左侧丘脑，右侧顶叶，左侧前扣带回。增强的脑区有：左侧楔前叶，左侧顶上小叶。（4）缺陷组与非缺陷组比较，后扣带回功能连接减弱的脑区有：右侧顶叶，左侧楔前叶。增强的脑区：左、右侧额下回，左侧额上回（背侧），左侧颞叶。结论缺陷型精神分裂症可能存在特定的后扣带回功能连接网络模式，存在左侧边缘叶、双侧额中回等脑区连接减弱，提示缺陷型精神分裂症可能为一种独立的疾病亚型。

Objective To explore the discrepancies of the network of resting brain functional connectivity related to posterior cingulated cortex （PCC） between deficit schizophrenia patients and normal control. Methods Thirty male patients of deficit schizophrenia, nondefieit schizophrenia and 30 healthy controls were eraoiled, and the age, education level and sex were matched between three groups. Resting state fMRI was performed on all the subjects. Correlation analysis between PCC and all the other voxels in the brain was performed with a voxel-wise manner and the changes of network of PCC functional connectivity between three groups were compared. Results There were valid data of 27 patients in deficit group, 26 patients in nondefieit group, 25 persons in control group. The scores of SANS （ 26. 7 ± 2.4 ） and SDS （ 11.2 ± 2.7） in deficit group were higher than that in nondeficit group （ 14.3 ± 2,4.1±2.6 ; t = 23. 667,9. 812,P 〈 0. 01 ）. （2）In three groups, areas showing significant functional connectivity to PCC included left and right middle frontal gyms, left and right superior frontal gyms, left inferior frontal gyms, left and right cerebellum, left and right posterior lobe of cerebellum, left inferior temporal gyms, right middle temporal gyms, left caudate nucleus, left and right limbic lobe （parahippocampal gyms ）, left cuneate lobe, left and right precuneus. （3）Tile weaker functional connectivity to PGC in deficit schizophrenia patients than normal control included areas of left and right middle frontal gyms, left and right cerebellum, left limbic lobe, left thalamus, right parietal lobe, the left anterior cingulated cortex, while stronger connectivity in areas of left precuneus and left parietal lobule. （4）The weaker functional connectivity to PCC in deficit schizophrenia patients than non-deficit schizophrenia patients included areas of right parietal lobule and left precuneus, while stronger connectivity were in areas of left and right inferior frontal gyrus, left superior frontal gyms, left temporal lobe. Conclusions Deficit schizophrenia may exist specific PCC functional connectivity network mode, and the weakened brain regions connection be in left limbic lobe,left and right middle frontal gyrus and so on. It suggests that deficit schizophrenia may be an independent disease subtype.