偏执型精神分裂症患者脑血流及其连通性变化

Changes of cerebral blood flow and its connectivity in patients with paranoid schizophrenia

目的:探讨偏执型精神分裂症(PSZ)患者脑血流(CBF)及其连通性变化。方法:利用3.0T磁共振扫描仪分别对62例PSZ患者(PSZ组)和41名性别、年龄相匹配的健康对照者(HC组)进行高分辨率三维(3D)T1加权和3D动脉自旋标记(ASL)扫描;采用双样本t检验及Pearson相关分析PSZ患者的脑血流及其连通性的变化,以及这种变化与临床症状的相关性。结果:与HC组相比,PSZ组右侧壳核、左侧尾状核CBF增高,左侧额上回CBF降低(团块水平FWE校正,P<0.001);且左侧尾状核CBF增高与敌对猜疑因子量表评分呈正相关(r=0.34,P<0.01);左侧尾状核CBF与左侧中扣带回、右侧小脑CBF的连通性显著降低(团块水平FWE校正,P<0.001),与双侧嗅皮质的连通性显著增高(团块水平FWE校正,P<0.001),左额上回CBF与右颞下回CBF的连通性显著降低(团块水平FWE校正,P<0.001)。结论:PSZ患者存在CBF及其连通性改变,可能与其临床敌对、猜疑等症状有关。

Objective:To investigate the changes of cerebral blood flow(CBF) and its connectivity in patients with paranoid schizophrenia(PSZ).Method:62 PSZ patients and 41 healthy controls(HC group) with matched sex and age were enrolled.High-resolution three dimensional(3 D) T1-weighted and 3 D arterial spin labeling(ASL) were performed on all subjects with 3.0 T magnetic resonance scanner.Two-sample t test and Pearson correlation analysis were used to explore the changes of CBF and its connectivity in patients with PSZ,as well as the correlation between the changes and clinical symptoms.Results:Compared with HC group,the CBF of right putamen and left caudate nucleus in PSZ patients increased,while that of left superior frontal gyrus decreased(cluster-level FWE-corrected,P<0.001).The CBF increase in left caudate nucleus was positively correlated with hostile suspiciousness(r=0.34,P<0.01).The connectivity of the left caudate nucleus with the left middle cingulate gyrus and the right cerebellum was significantly reduced(cluster-level FWE-corrected,P<0.001),the connectivity with bilateral olfactory cortex was significantly increased(cluster-level FWE-corrected,P<0.001),and the connectivity between the left superior frontal gyrus and the right inferior temporal gyrus was significantly reduced(cluster-level FWE-corrected,P<0.001).Conclusion:Patients with PSZ have changes in CBF and connectivity,which may be related to their hostile and suspicious symptoms.