首发未用药精神分裂症病人壳核及伏隔核静息态功能连接的研究

Resting-state functional MRI study on the functional connectivity of the putamen and the nucleus accumbens in the first-episode untreated schizophrenic patients

目的采用基于兴趣区相关性的方法研究首发未用药精神分裂症(SCH)病人壳核和伏隔核的静息态功能连接。方法纳入首发未用药SCH病人25例和健康对照32例,均行静息态功能MRI检查和临床功能评估(包括韦氏记忆量表第3版空间广度测验、连线测试、简易视觉空间记忆测验-修订版、阳性与阴性症状量表)。在Matlab平台上使用脑成像数据处理和分析工具对2组的静息态功能MRI数据进行预处理,分别选取双侧壳核和伏隔核为兴趣区与全脑其他体素时间序列进行Pearson相关分析,获得的功能连接值采用两样本t检验比较组间差异。最后,在病人组中提取2组间存在差异脑区的功能连接系数,与4种临床功能评估结果进行偏相关分析。结果与健康对照组相比,病人组右侧壳核与左侧舌回、右侧伏隔核与下丘脑/右侧海马旁回、左侧伏隔核与下丘脑的功能连接均减弱(体素水平P<0.001,高斯随机场理论校正,簇水平P<0.05)。病人组右侧伏隔核-下丘脑/右侧海马旁回连接系数与韦氏记忆量表第3版空间广度测验评分呈正相关(r=0.533,P=0.009)。结论首发未用药SCH病人右侧壳核、双侧伏隔核分别存在功能失连接表现,可能是病人存在认知障碍的原因之一。

Objective To study the functional connections between the putamen and the nucleus accumbens at resting-state in the first-episode untreated schizophrenic(SCH) patients based on the correlations of the regions of interest.Methods A total of 25 SCH patients and 32 healthy controls were enrolled, all patients underwent resting-state functional MRI and clinical function assessment, including Wechsler memory scale-Ⅲ spatial span test, trail making test, brief visuospatial memory test revised, and positive and negative symptom scale. The resting-state functional MRI data were preprocessed using the Data Processing and Analysis for Brain Imaging tool on Matlab platform. The bilateral putamen and nucleus accumbens were selected as the regions of interest for Pearson correlation with other voxel time series of the whole brain. The functional connectivity data were compared by two-sample t-test. The functional connectivity coefficients of the patient group were extracted from brain regions where showing significant difference between the two groups, and its association with 4 clinical functional assessments was performed with partial correlation analysis. Results Compared with the healthy control group, the functional connections between right putamen and left lingual gyrus, right nucleus accumbens and hypothalamus/parahippocampal gyrus, left nucleus accumbens and hypothalamus were all weakened(voxel level P <0.001, Gaussian Random Field Theory correction at cluster level P <0.05). The functional connectivity of right nucleus accumbens-hypothalamus/right parahippocampal gyrus was positively correlated with Wechsler memory scale-Ⅲ spatial span test score(r=0.533, P=0.009). Conclusions The functional disconnection between right putamen and bilateral nucleus accumbens in the first-episode untreated SCH patients may be one of the reasons for the cognitive impairment in the patients.