Granger因果检验对创伤后应激障碍杏仁核效应连接网络的研究

Altered effective connectivity network of the amygdala in posttraumatic stress disorder:a study based on granger causality analysis

目的探讨创伤后应激障碍(posttraumatic stress disorder,PTSD)患者杏仁核与全脑其它脑区间效应连接的改变。方法对经历汶川大地震的57例PTSD患者及77例对照行静息状态下的功能磁共振扫描,采用Granger因果(granger causality,GC)检验方法分析双侧杏仁核与全脑其它脑区间影响的因果关系,进行组间比较并计算患者的临床用PTSD诊断量表(clinician-Administered PTSD Scale,CAPS)评分和异常脑区GC平均值的相关性。结果与对照组相比,PTSD患者杏仁核对内侧额回、扣带回、额上回、额下回、颞上回、颞下回和壳核的影响减弱,对海马和海马旁回、楔叶、楔前叶、丘脑的影响增强;而内侧额回、额中回、颞上回、颞中回、岛叶和壳核对杏仁核的影响减弱,楔叶、楔前叶和海马旁回对杏仁核的影响增强。PTSD患者的CAPS评分与杏仁核对颞上回和颞下回,额中回对杏仁核的影响呈负相关;而与杏仁核对楔前叶的影响呈正相关。结论 PTSD患者杏仁核与全脑其它脑区间的效应连接存在广泛异常,且与患者的症状严重程度相关。

Objective To explore the alteration of the effective connectivity between amygdala and other brain regions in posttraumatic stress disorder （PTSD） patients .Methods Fifty-seven patients with PTSD and seventy-seven controls who survived from the Wenchuan earthquake underwent the resting-state functional magnetic imaging scan .Granger causality analysis was used to compare the effective connectivity network of amygdala between PTSD patients and controls .In addi-tion ,Pearson correlation was performed between abnormal Granger causality and the Clinician-Administered PTSD Scale （CAPS） score of patients .Results Compared with controls ,PTSD patients showed decreased influence from amygdala to medial frontal gyrus ,cingulate cortex ,superior and inferior frontal gyri ,superior and inferior temporal gyri ,putmen ,and inceased influence from amygdala to hippocampus ,parahipocampal gyrus ,cuneus ,precuneus and thalama .Furthermore ,PTSD patients exhibited decreased influence from medial and middle frontal gyri ,superior and middle temporal gyri ,insu-lar ,putamen to amygdala ,and increased influence from cuneus ,precuneus and parahippocampal gyrus to amygdala .The CAPS score was negatively correlated with effective connectivity from amygdala to superior and inferior temporal gyri , from middle frontal gyrus to amygdala ,and positively correlated with effective connectivity from amgdala to precuneus . Conclusion The effective connectivity network of amygdala is widespreadly disrupted in PTSD patients ,and is partly cor-related with their disease severity .