精神分裂症默认网络的静息态fMRI研究

A comparative study of resting state fMRI on default mode network in patients with schizophrenia

目的探讨精神分裂症患者静息态默认网络功能连接情况及非典型抗精神病药物对其的短期影响效应。方法采用3.0T功能磁共振技术(f MRI)检测33例未用药的急性期精神分裂症患者(研究组)与33名健康人(对照组)静息态下脑功能连接情况。并对26例患者在非典型抗精神病药物治疗前后进行f MRI及阳性和阴性综合征量表(PANSS)评定。结果与对照组相比,研究组默认网络中右侧小脑后叶、右侧顶下小叶、右侧后扣带回/楔前叶功能连接增高,左侧额内侧回、左侧楔前叶、左侧额上回功能连接降低。研究组中,默认网络左侧楔前叶的平均Z值与PANSS总分、阴性症状因子呈负相关(P<0.05),左侧额上回的平均Z值与阴性症状因子分呈负相关(P<0.05)。在26例完成治疗的患者中,与治疗前相比,默认网络中右侧颞上回、右侧额内侧回、左侧额上回功能连接增高,右侧后扣带回/楔前叶功能连接降低。结论精神分裂症患者存在静息态默认网络的功能连接异常,前额叶、右侧后扣带回/楔前叶脑区可能是默认网络的关键脑区,非典型抗精神病药物可改变其功能连接状况。

Objective To explore functional connectivity （FC） of resting state functional magnetic resonance imaging （fMRI） on default mode network （DMN） and short-term effects of atypical antipsyehotics on it in patients with schizophrenia. Methods A total of 33 untreated patients with schizophnia in study group and 33 healthy people in control group were selected and examined with fMRI for FC of resting state. A total of 26 patients with schizophrenia were treated with atypical antipsychotics and exmined with fMRI, assessed with Positive and Negative Syndrome Scale（PANSS） before and after treatment. Results The FCs of right cerebellum posterior lobe, right inferior parietal lobule, right posterior cingulate/precuneus in study group all significantly increased compared with those in control group, and the FCs of left medial frontal gyrus, left precuneus, left superior frontal gyrus in study group all significantly decreased compared with those in control group. In study group, the average Z value of left precuneus was negatively related to the negative factor score and total score of PANSS（ P 〈 0.05 ） and the average Z value of left superior frontal gyrus was negatively related to the negative factor score of PANSS （ P 〈0. 05 ）. In 26 patients with treatment of atypical antipsychotics, the FCs of right superior temporal gyms, right medial frontal gyrus, left superior frontal gyrus after treatment all significantly increased compared with those before treatment, and the FC of right posterior cingulate/precuneus after treatment significantly decreased compared with that before treatment. Conclusion There is abnormal FC of resting state fMRI on DMN in the patients with schizophrenia and the prefrontal cortex, right posterior cingulate/precuneus may be the key brain regions which could be changed by the treatment of atypical antipsychotics.