基于静系统功能磁共振的躯体化障碍默认网络的自发神经活动研究

The research of rs-f MRI in spontaneous neural activity of default network of somatization disorder

目的探讨运用静系统功能磁共振(rs-f MRI)方法研究躯体化障碍默认网络的自发神经活动的机制。方法选取2014年6月至2016年8月于我院就诊的躯体化障碍患者共80例(观察组),取80例名年龄、性别、教育程度均匹配的健康体检者作为对照组。所有患者均使用HAMD量表、和SCL-90量表的躯体化障碍因子分量表评估,并进行rs-f MRI扫描分析。结果其中观察组患者HAMD、HAMA和躯体化障碍因子评分显著高于对照组(P<0.01),观察组较正常对照组f ALFF增高脑区为位于DMN前部的双内侧前额叶(MPFC)上部(Voxels=66,t=4.43),减弱脑区为位于DMN后部的左模前叶(PCu)(Voxels=74,t=-4.66),观察组双MPFC上部的簇的Z值与SCL-90的躯体化障碍因子分数呈正相关(P<0.01,cluster size>52 voxel),与年龄、教育年限、病程、HAMD、HAMA评分无显著相关性。结论躯体化障碍患者DMN神经活动存在分离模式,MPFC的f ALFF值可作为判断躯体化症状严重程度的指标。

Objective To study the mechanism rs-fMRI in spontaneous neural activity of default network in somatization disorder. Methods From June 2014 to August 2016, 80 patients with somatization disorder（observation group）and 80 cases of age,gender,education level matched healthy case（control group）were selected in our hospital. All patients were using HAMD,HAMD and SCL–90 in somatization disorder factor table＇s assessment,and rs-f MRI were used to analyse the results. Results The observation group of patients with HAMD,HAMA and somatization disorder factor score was higher than the control group（P〈0.01）. Comparing with the normal control group,the increased fALFF brain region of observation group was located in the front of DMN＇s double the medial prefrontal cortex（MPFC）,the reduced brain area of observation group was located in the anterior left module at the back of the DMN（PCu）,（P〈0.01,the cluster size 52 voxel）,the observation group double MPFC Z value of the upper part of the cluster and somatization disorder of SCL-90 factor scores were positively correlated（P〈0.01,the cluster size 52voxel）,and age,education,age,course of diseases,HAMD,HAMA scores had no significant correlation. Conclusion There is DMN neural activity separated model in the Somatization disorder,fALFF value of MPFC can be an index of judging the severity of somatization symptoms.