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目的采用fMRI技术探讨精神分裂症患者空间工作记忆损害的神经机制。方法收集18例精神分裂症患者和18名正常受试者进行空间n-back任务的fMRI扫描。采用SPM 8进行数据预处理和统计分析,单样本t-检验用于分析两组各自脑激活结果,双样本t-检验用于工作记忆相关脑激活的组间比较。采用FDR方法进行多重比较校正。利用SPSS 17.0软件对工作记忆任务中的行为学结果 (正确率和反应时间)进行组间比较。结果与对照组相比,精神分裂症患者空间工作记忆任务反应时间延长(882.00±50.31)ms,正确率下降(83.60±2.90)%(P<0.05)。精神分裂症患者在n-back空间工作记忆任务时所激活的脑区分布与对照组基本一致,主要包括双侧前额皮层、颞顶叶皮层及部分基底核团。但组间比较显示精神分裂症患者多个脑区激活强度及范围明显增加,包括双侧前额皮层背外侧、双侧后顶叶皮层、右侧中央前回、左侧颞中回、右扣带回和双侧小脑(FDR校正,P<0.05)。结论执行空间工作记忆任务时精神分裂症患者脑区激活增加,但行为学表现下降,提示患者脑区活动效率低下,可能是工作记忆能力损害的神经基础。
Objective To investigate the neural mechanism of spatial working memory impairment in patients with schizophrenia by fMRI technique. Methods FMRI scans of n-back tasks in 18 schizophrenic patients and 18 normal subjects were collected. Data preprocessing and statistical analysis were performed using SPM 8, a single-sample t-test was used to analyze brain activation results from both groups, and a two-sample t-test was used to compare working-memory-related brain activation. FDR method for multiple comparison and correction. The behavioral results (accuracy and response time) in working memory tasks were compared between groups using SPSS 17.0 software. Results Compared with the control group, the response time of spatial working memory task in patients with schizophrenia was prolonged (882.00 ± 50.31) ms, and the correct rate decreased by 83.60 ± 2.90% (P <0.05). The distribution of brain regions activated by schizophrenia in n-back working memory task was basically the same as that of the control group, including bilateral prefrontal cortex, temporal parietal cortex and some basal ganglia. However, there was a significant increase in the intensity and range of activation in multiple brain regions in patients with schizophrenia, including dorsolateral prefrontal cortex, bilateral posterior parietal cortex, right middle anterior gyrus, left temporal gyrus, right cingulate gyrus And bilateral cerebellum (FDR corrected, P <0.05). Conclusions The activation of brain regions in patients with schizophrenia during spatial working memory task is increased, but the behavioral performance is decreased, suggesting that brain activity in patients is inefficient and may be the neural basis for the impairment of working memory.