摘要
目的:探究极重度烧伤后病人的精神障碍,并用独立成分分析方法探究这类病人脑的静息态默认网络的改变.方法:收集单次事故中深Ⅱ度及Ⅲ度烧伤面积均大于90%,经治疗后无创面的极重度烧伤病人23例,由精神科医生根据DSM-Ⅳ标准对病人的精神障碍做出诊断和评估.同时采集静息态Blood oxygenation level dependent(BOLD)图像,并招募性别、年龄、受教育程度匹配的健康被试作为对照,应用独立成分分析方法分离脑的静息态默认网络,进一步统计检验推断创伤后病人脑的静息态默认网络的改变,对组间差异脑区的网络连接强度与精神量表评分做相关分析.结果:本研究收集的所有病人均符合创伤后应激障碍伴抑郁诊断,影像学数据显示病例组背内侧前额叶、楔前叶/后部扣带回、右侧后部颞上沟皮层静息态网络连接强度减低.与创伤后应激障碍量表(PCL-17)评分的相关分析未见显著相关性.结论:极重度烧伤是诱发创伤后应激障碍、抑郁等精神障碍的高危因素;极重度烧伤病人创伤后脑的静息态默认网络中参与社会认知的多个脑区网络连接强度降低可能是病人负性症状和负性社会认知的重要神经机制.
Objective:To assess the mental disorder following the extremely sever burn trauma and explore the abnormalities in the default network of resting-state functional magnetic resonance by independent component analysis.Methods:Twenty-three burned patients with the total burned body surface area of deep-Ⅱ or Ⅲ>90%,who survived from a certain evident and recovered,were enrolled.The mental disorder was diagnosed according to diagnostic and statistical manual of mental disorders Ⅳ-TR,and psychological assessments were performed by psychiatrists.The resting blood oxygenation level dependent(BOLD)functional magnetic resonance images of the patients and the matched healthy controls were acquired.The independent components of the default mode network(DMN)were separated and recognized by multiple regression in GIFT.The group differences of the DMN were inferred by t tests,and the correlation analysis between the intensities of networks in these bolds and the PCL-17 were performed.Results:All the patients matched the diagnosis of post-traumatic stress disorder with depression.The areas dorsal medial prefrontal cortex,precuneus/posterior cingulate cortex and posterior part of right superior temporal sulcus showed the decreased intensities in the DMN,but failed showed the correlation with scores of the PCL-17.Conclusion:The patients suffering extremely sever burn trauma are vulnerable to mental disorders.The decreased connectivity of the bolds,which are deeply involved in social cognition,in the DMN could be the partial causes of the negative symptoms and dysfunctions among the patients.
作者
邢炯
储兴
丁羚涛
乔红艳
刘加成
XING Jiong;CHU Xing;DING Ling-tao;QIAO Hong-yan;LIU Jia-cheng(The Affiliated Hospital of Jiangnan University,Wuxi Jiangsu 214041,China;Department of Nuclear Medicine,Zhongda Hospital,Southeast University,Nanjing 210009,China)
出处
《中国临床医学影像杂志》
CAS
2020年第12期851-854,共4页
Journal of China Clinic Medical Imaging
基金
国家自然科学基金面上项目(81571653)。
关键词
烧伤
磁共振成像
Burns
Magnetic resonance imaging