抑郁症与精神分裂症患者纹状体功能连接异常的静息态功能磁共振研究

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目的:探讨抑郁症与精神分裂症患者纹状体功能连接特点及其与临床症状的相关性。方法:纳入2015年3月至2019年2月于武汉大学人民医院精神卫生中心就诊的抑郁症患者(抑郁症组,n n=36)和精神分裂症患者(精神分裂症组,n n=36),以及性别、年龄及受教育程度与患者组相匹配的健康对照者(对照组,n n=36)进行HAMDn 17、HAMA和PANSS评估以及静息态功能磁共振成像(resting-state functional magenetic resonance imaging, rs-fMRI)扫描,计算3组局部一致性(regional homogeneity, ReHo)值及比率低频振幅(fractional amplitude of low frequency fluctuation, fALFF)值,基于方差分析结果将异常脑区进行叠加得到重叠脑区;最后以重叠脑区作为感兴趣区域(region of interest, ROI)进行全脑功能连接分析,采用Pearson相关分析异常脑区的功能连接值与抑郁症及精神分裂症患者临床症状的相关性。n 结果:3组ReHo值存在差异的脑区为左侧纹状体延伸至脑岛及罗兰岛盖(AlphaSim校正,n P99);3组fALFF值存在差异的脑区为左侧顶上回及双侧脑岛延伸至纹状体(AlphaSim校正,n P90),3组ReHo及fALFF值存在差异的脑区叠加后交集的脑区为左侧纹状体;以重叠脑区作为感兴趣区域进行全脑功能连接分析显示,3组左侧纹状体与左侧颞下回存在功能连接异常(AlphaSim校正,n P42);事后两两比较显示,与对照组(0.24±0.03)比较,抑郁症组(0.15±0.02)与精神分裂症组(0.09±0.01)左侧壳核与颞下回功能连接均减弱;而精神分裂症组较抑郁症组左侧壳核与颞下回功能连接减弱更为显著(n P<0.05)。Pearson相关分析显示左侧颞下回功能连接值与抑郁症组HAMDn 17评分无相关(n r=-0.02,n P=0.93);与精神分裂症组PANSS阳性评分呈负相关(n r=-0.40,n P=0.02)。n 结论:抑郁症及精神分裂症患者均存在纹状体异常功能连接的特点,且左侧纹状体与左侧颞下回功能连接异常与精神分裂症阳性症状密切相关。纹状体脑功能活动及其与颞下回功能连接异常在抑郁症与精神分裂症的病理机制中可能发挥重要作用。“,”Objective:To compare and explore the characteristics of striatum functional connectivity in major depression and schizophrenic.Methods:Thirty-six patients with major depressive disorder (MDD), schizophrenia, and health controls were recruited in this study. All subjects underwent rest-stating functional magnetic resonance imaging (rs-fMRI). Routine preprocessing of rs-fMRI data was performed. The regional homogeneity (ReHo), and fractional amplitude of low frequency fluctuation (fALFF) values of the three groups were calculated, separately. Based on the results of one-way analysis of covariance, different brain areas were superimposed to obtain the overlapping regions (the left striatum). Next, the superimposed brain region (the left striatum) was used as the region of interest (ROI), and the customized ROI method was used for the whole-brain functional connectivity analysis. Finally, Pearson correlation analysis was performed between the functional connectivity of the brain regions and clinical features of MDD and schizophrenia.Result:Among the three groups, left striatum extending to the insula and Rolland′s insula showed significant differences of the ReHo values (n P99);while left superior parietal areas and bilateral insula extending to lentiform nucleus showed significant differences of fALFF values (AlphaSim correction,n P90). The left striatum were superimposed and revealed significant ReHo and fALFF values. The ROI analysis showed that the brain area with different functional connections in the three groups was left inferior temporal gyrus (AlphaSim correction,n P42). The pairwise comparative analysis showed that compared with healthy controls (0.24±0.03), patients with MDD (0.15±0.02) and schizophrenia (0.09±0.01) showed decreased functional connections between the left striatum and the inferior temporal gyrus, and the decline was more significant in patients with schizophrenia. The functional connectivity value of left inferior temporal gyrus was not correlated with HAMD score in MDD(n r=-0.02,n P=0.93). The functional connectivity value of left inferior temporal gyrus was positively correlated with PANSS positive score in patients with schizophrenia (n r=-0.40, n P=0.02).n Conclusion:Both MDD and schizophrenia patients may have abnormal function connections of the striatum and the abnormal function connection with the left temporal inferior gyrus may closely related to clinical symptoms of schizophrenia. The brain function activity of striatum and its abnormal connection with the left temporal inferior gyrus may play an important role in the neuropathology of schizophrenia and MDD.
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