首发未治疗精神分裂症患者的尾状核脑熵与PANSS阳性症状的相关性

The study on the correlation between caudate entropy and positive symptoms of PANSS in first-episode untreated schizophrenia

目的探讨首发未治疗的精神分裂症患者静息态脑熵功能的异常模式,探索临床症状的潜在神经机制。方法本地招募49例(男性26例,女性23例)首发未治疗的精神分裂症患者为被试组及人口学相匹配的38例为健康对照组(男性21例,女性17例),经阳性和阴性综合征量表(PANSS)评估后使用GE Signa HDxt扫描仪采集静息态fMRI和T13D结构数据。MRI数据经dpabi预处理后计算各被试静息态全脑脑熵,并使用两样本t检验进行组间对比(P<0.05,GRF校正)。对被试组患者,提取差异区脑熵信号与PANSS阳性和阴性指标进行spearman偏相关分析(P<0.05为显著性),以年龄、教育程度为控制变量。结果相比对照组,被试组在右侧楔前叶脑熵显著增强、右侧尾状核脑熵显著降低(P<0.05,GRF校正);被试组右侧尾状核脑熵值与PANSS阳性症状总分存在显著的正相关(P=0.014,rho=0.36)。结论楔前叶与其它脑区的同步性受损影响其调控复杂和高度整合任务是精神分裂症的发病机制,而尾状核在病症中可能具有功能可塑性和代偿性,是潜在的治疗和缓解精神分裂症状的靶点。

Objective To study the aberrant pattern of resting-state(rs)brain function in the first-episode untreated schizophrenia patients,and to explore the potential neural mechanism of clinical symptoms.Methods A total of 49 first-episode untreated schizophrenia patients(male=26,female=23)and 38 healthy controls(male=21,female=17)matched for demographics were recruited locally.After assessment by PANSS,rs-fMRI and T13D structural data were collected using a GE Signa HDxt scanner.After pre-processing of MRI data,the whole brain entropy(BEN)was calculated for each subject,and two-sample t-test was used to compare group differences(P<0.05,GRF corrected).For the schizophrenia group subjects,the mean brain entropy signals of the different brain areas were extracted,together with the PANSS scores that were analyzed using spearman partial correlation(age,education level as controlled variables).Results Compared with the control group,BEN of the schizophrenia group was significantly enhanced in the right precuneus and significantly reduced in the right caudate nucleus(cluster P<0.05,GRF corrected).There was a significant positive correlation between caudate BEN and total scores of positive symptoms in PANSS(P=0.014,rho=0.36).Conclusion The impaired synchrony of the precuneus and other brain regions affects the complex and highly integrated task in schizophrenia patients.The caudate nucleus may have functional plasticity and compensatoryness in the schizophrenia.Caudate may serve as a potential target in treatment and relieving symptoms of schizophrenia.