有氧运动对慢性精神分裂症患者认知功能及静息态脑功能的影响

The effects of aerobic exercise on cognition and regional homogeneity of resting state functional magnetic resonance imaging in patients with chronic schizophrenia

目的探讨有氧运动对慢性精神分裂症患者认知功能及静息态脑功能局部一致性(ReHo)的影响。方法选取40例病情稳定的慢性精神分裂症患者为研究对象,随机分为试验组与对照组(n=20),对照组患者在住院期间给予常规抗精神病药物治疗和健康宣教,试验组在此基础上进行为期5个月的有氧运动干预。分别于干预前后采用阳性与阴性症状量表(PANSS)和可重复的神经心理状态评定量表(RBANS)对患者进行评估,并进行静息态功能磁共振(rs-fMRI)扫描,应用基于ReHo的方法进行影像学数据分析。并将ReHo值变化与PANSS和RBANS评分进行相关性分析。结果有氧运动干预后,试验组阴性症状分、一般精神病理症状分、和PANSS总分均显著低于对照组(P<0.05),试验组即刻记忆、延时记忆及RBANS总分也显著高于对照组(P<0.05)。有氧运动干预后试验组右侧颞中回ReHo值较前减低(AlphaSim校正,P<0.05),但与RBANS及PANSS各项评分均无相关性。结论有氧运动疗法对慢性精神分裂症患者的精神症状和认知功能均有积极的改善作用,同时发现有氧运动后患者右侧颞中回局部一致性减低。

Objective To explore the effects of aerobic exercise on cognitive function and regional homogeneity(ReHo)of resting state functional magnetic resonance imaging in patients with chronic schizophrenia.Methods 40 patients with stable chronic schizophrenia were randomly divided into experimental group and control group randomly(n=20).Patients in the control group received routine antipsychotic drugs and health education during hospitalization,and the experimental group was given aerobic exercise intervention for five months on this basis.Before and after the intervention,the patients were evaluated with Positive and Negative Symptom Scale(PANSS)and the Repeatable Battery for the Assessment of Neuropsychological Status(RBANS),and were scanned with resting functional magnetic resonance imaging(rs-fMRI).The imaging data were analyzed by the method based on ReHo.Paired t-test was used for comparison before and after intervention,and independent t-test was used for comparison between groups,and the correlation between the difference of ReHo value and the change of PANSS as well as RBANS was analyzed.Results After aerobic exercise intervention,the scores of negative symptoms,general psychopathological symptoms and total scores of PANSS in the experimental group were significantly lower than those in the control group(P<0.05),and the scores of immediate memory,delayed memory and total scores of RBANS were significantly higher than those in the control group(P<0.05).After aerobic exercise intervention,the ReHo value of the right middle temporal gyrus in the experimental group was lower than before(AlphaSim correction,P<0.05),but there was no correlation with RBANS and PANSS.Conclusion Aerobic exercise can improve the mental symptoms and cognitive function of patients with chronic schizophrenia,and it is found that the regional homogeneity(ReHo)of the right middle temporal gyrus decreasesafter aerobic exercise.