男性偏执型精神分裂症患者脑结构网络全局效率与精神症状相关性研究

The global efficiency of the brain structural networks and its relationship with the psychotic symptoms in male paranoid schizophrenia

目的探讨男性偏执型精神分裂症患者脑结构网络全局效率属性的改变及其与精神症状的相关性。方法对27例男性偏执型精神分裂症患者（患者组）、28例男性健康者（对照组）进行弥散张量成像扫描（diffusion tensor imaging，DTI），利用解剖学自动标记模板（automatedanatomicallabeling，AAL）将整个大脑划分为90个区域，对大脑进行确定性纤维追踪（fiber assignment by continuoustracking，FACT），构建脑结构二值化网络。对所得两组脑网络的网络平均全局效率属性值和节点全局效率属性值进行双样本t检验，并对节点的全局效率属性值与阳性与阴性症状量表（positive and negative syndromescale，PANSS）各项分值进行相关分析。结果与对照组比较，患者组脑网络平均全局效率属性值下降（7．87±0．56，8．17±0．56，P=0．005），左侧眶部额上回（P=0．00025）、左侧顶上回（P=0．00011）、左侧楔叶（P=0．00012）、左侧壳核（P=0．00032）节点全局效率属性值下降，均通过FDR校正。患者组左侧壳核全局效率属性值与PANSS总分（r=-0．43，P=0．03）、阳性因子分（r=-0．41，P=0．03）、认知因子分（r=-0．40，P=0．04）呈负相关。结论男性偏执型精神分裂症患者左额顶枕相关皮质以及皮质下相关结构的信息传输与整合效率的下降与其疾病的发生相关，同时皮质下结构工作效率的下降与精神分裂症患者阳性症状和认知功能损害相关。

Objective To explore the differences of the global efficiency of the brain structural networks between the male paranoid schizophrenia and male healthy and its relationship with the psychotic symptoms of the schizophrenia. Methods The diffusion tensor imaging data were obtained from 27 male paranoid schizophrenia patients and 28 male healthy controls. The whole cerebral cortex was parcellated into 90 regions by the anatomical label map. Tractography was perfoxned in the whole cerebral cortex of each subject to reconstruct white matter tracts of the brain using fiber assignment by continuous tracking（FACT） algorithm. And then the brain structural binary networks were constructed using the complex network theory. The average global efficiency of the brain network and the global efficiency of the nodes of both groups were examined by two sample t -test and its relationship with the psychotic symptoms in the male paranoid schizophrenia was explored by the correlation analysis. Results Com pared with control group, the average global efficiency of the brain network of the patients decreased significantly （7.87±0.56,8.17±0.56, P= 0.005 ） , and the global efficiency of the nodes in the brain network of the patient de- creased significantly in the left superior frontal gyrus （orbital part） （P= 0.00025 ） , the left superior parietal gyrus （P= 0.00011 ）, the left cuneus （P= 0.00012） and the left putamen （P= 0.00032） ,all survived FDR correction. Sig- nificant negative COlTelation was found between the global efficiency of the left putamen and the total scores （ r= -0.43, P=0.03）,the positive scores （ r=-0.41, P= 0.03） and the cognitive scores （ r=-0.40, P= 0.04） of PANSS.Conclusion The decreased global efficiency of the left frontal, parietal and occipital lobes and the subcortical structures lead to the occurrence of schizophrenia. And the reduced efficiency of the subcortical structures is associated with the positive symptoms and the abnormal cognitive function of the patients.