精神分裂症伴迟发性运动障碍患者静息态脑功能低频振幅研究

Altered amplitude of low-frequency fluctuations in patients with schizophrenia and tardive dyskinesia: A resting state fMRI study

目的:采用低频振幅(ALFF)指标评估精神分裂症伴迟发性运动障碍(TD)患者静息态脑功能活动及其与TD临床症状之间的关系。方法:对32例精神分裂症伴TD的患者(TD组),31例精神分裂症不伴TD的患者(非TD组)和32名正常对照(正常对照组)进行静息态脑功能磁共振扫描。分别使用阳性症状与阴性症状量表(PANSS)、异常不自主运动量表(AIMS)及重复性成套神经心理状态测验(RBANS)评估精神症状、异常不自主运动严重程度及认知功能。使用单样本t检验和单因素方差分析及事后比较t检验进行ALFF组内统计和组间比较。运用Pearson相关分析研究感兴趣区ALFF信号值与TD临床特征的关系。结果:TD组PANSS阴性症状得分高于非TD组[(22±5)vs.(17±6),P<0.01],视觉广度认知得分低于非TD组[(72±14)vs.(82±15),P<0.01]。TD组在右侧枕上回和楔叶的ALFF信号值低于非TD组(P<0.01,Alpha Sim校正)。相关分析显示TD组样本在右侧枕上回和楔叶的ALFF值与AIM S总分之间呈弱负相关(r=-0.38),视觉广度认知得分与AIM S总分之间也呈弱负相关(r=-0.44),均有统计学意义(P<0.05)。结论:本研究提示精神分裂症伴TD患者在静息状态下存在脑自发性神经活动异常,以枕上回和楔叶较为显著,并可能与TD的临床症状相关。

Objective： To explore the resting-state brain activity and its relationship with clinical traits in schizophrenia patients with tardive dyskinesia（ TD） with the index of amplitude of lowfrequency fluctuations（ ALFF）. Methods： Resting-state functional MRI data were acquired from 32 schizophrenia patients with TD（ TD group）,31 without TD（ non-TD group） and 32 normal controls（ NC group）. The psychopathological symptoms,severities of TD,and cognitive functions were assessed with the Positive and Negative Syndrome Scale（ PANSS）,Abnormal Involuntary Movement Scale（ AIMS）,and Repeatable Battery for the Assessment of NeuropsychologicalStatus（ RBANS）,respectively. One sample t-test,one way analysis of variance and post-hoc t-tests were performed to analyze ALFF values within group and differences between groups. Pearson correlation coefficients were calculated to explore the relationship between ALFF values in regions of interest（ ROIs） and clinical traits of TD. Results：Compared to non-TD group,TD group demonstrated significant higher PANSS negative score [（ 22 ± 5） vs.（ 17 ±6）,P〈0. 01 ],poorer visuospatial/constructional index score [（ 72 ± 14） vs.（ 82 ± 15）; P = 0. 004 ],and significantly lower ALFF in right superior occipital gyrus（ SOG） and cuneus（ P〈0. 01,Alpha Sim correction）. Correlation analysis showed that in TD group the AIMS total score have weak but significant negative correlation with the ALFF in the right SOG and cuneus（ r =-0. 38）, also with the visuospatial/constructional index score（ r =-0. 44）. Conclusion： This study suggests that abnormal resting-state brain regional spontaneous neuronal activity is associated with schizophrenia patients with TD,especially in the SOG and cuneus. Additionally,it is probably correlated with the clinical traits of TD.