不同诊断类型的言语性幻听症状间影像遗传学差异研究

Study on the genetic difference of images among the symptoms of different diagnostic types of verbal auditory hallucinations

目的探讨不同诊断类型的言语性幻听(AVHs)症状在COMT基因型和影像学中的差异情况。方法前瞻性选取2021年1月至2024年1月在温州市第七人民医院接受治疗的精神分裂症合并AVHs患者58例(精神分裂症组),单纯抑郁障碍合并AVHs患者42例(抑郁障碍组),另选同期在本院体检健康者50例作为对照组,记录3组研究对象的临床资料、COMT基因型和磁共振检测数据。结果3组COMT val158met基因型分布符合哈迪温伯格平衡(P>0.05)。3组val158met等位基因型频率和等位基因差异均无统计学意义(均P>0.05)。与对照组相比,精神分裂症组患者在左顶下小叶、右缘上回、左楔前叶及右内侧额上回的分数低频振幅(fALFF)值升高,在左辅助运动区、右中央后回及右舌回的fALFF值降低(均P<0.05)。与对照组相比,抑郁障碍组患者在右内侧额上回的fALFF值升高,在左辅助运动区、右中央后回、右舌回的fALFF值降低(均P<0.05)。精神分裂症组和抑郁障碍组患者不同脑区的fALFF值差异无统计学意义(均P>0.05)。结论精神分裂症合并AVHs患者楔前叶与顶下小叶神经活动加强,这可能是此类患者与单纯抑郁障碍合并AVHs患者导致AVHs症状的差异神经影像学基础。

Objective To analyze the differences in COMT genotype and imaging of different diagnostic types of verbal auditory hallucinations.Methods A total of 100 patients with schizophrenia and simple depressive disorder combined with AVHs who were treated in Wenzhou Seventh People's Hospital from January 2021 to January 2024 were prospectively selected as research objects,including 58 patients with schizophrenia and 42 patients with simple depressive disorder.Fifty healthy subjects in our hospital during the same period were selected as the control group,and the clinical data,and COMT genotype and magnetic resonance detection data of the three groups were recorded.Results The COMT val158met genotype distribution in schizophrenia,depression and control groups was consistent with the Hardy-Weinberg equilibrium(P>0.05).There were no significant differences in allele frequency and genotype frequency distribution of val158met among schizophrenia,depression and control groups(all P>0.05).Multiple comparisons showed that compared with the control group,fALFF values in the left inferior parietal lobule,right superior marginal gyrus,left anterior cuneus and right medial superior frontal gyrus were increased in schizophrenia group,while fALFF values in the left auxiliary motor area,right posterior central gyrus and right lingual gyrus were decreased(all P<0.05).Compared with the control group,fALFF values in the right medial superior frontal gyrus were increased in the depressed group,and fALFF values in the left auxiliary motor area,right posterior central gyrus and right lingual gyrus were decreased(P<0.05).There were no significant differences in fALFF values in different brain regions between schizophrenia and depression groups(all P<0.05).Conclusions The increased activity of the anterior cuneiform and inferior parietal lobules in patients with schizophrenia combined with AVHs may be the neuroimaging basis for the difference in AVHs morphology between such patients and those with simple depression combined with AVHs.