嗅觉刺激偏头痛患者的脑功能磁共振成像初步研究

目的观察偏头痛患者在嗅觉刺激下的脑功能磁共振成像(fMRI)变化, 分析其嗅觉相关脑网络特征。方法收集2021 年 1 月至 2022 年 1 月在川北医学院附属医院神经内科门诊确诊的27例偏头痛患者, 同期招募20名健康成年人作为对照组。收集所有受试者的人口学和临床特征资料。对所有受试者在嗅觉任务刺激下行同步fMRI扫描, 使用SPM12、Matlab2019b软件进行磁共振图像数据处理, 并结合SPSS 23.0软件进行统计学分析。结果对照组激活脑区包括左侧小脑、左侧颞下回、左侧梭状回、右侧额中回、右侧中央前回、脑岛、右侧中央沟盖、缘上回、右侧豆状壳核、中扣带回、中央旁小叶、顶上回(P<0.05)。偏头痛组激活脑区包括左侧小脑、右侧梭状回、右侧颞下回、右侧中央前回、右侧中央后回(P<0.05)。两组相比, 偏头痛组在右侧岛叶、右侧额中回眶部、左侧额下回眶部、右侧背外侧额上回、右侧颞上回、右侧枕上回、内侧和旁扣带脑回、右侧顶上回的激活强度弱于对照组(P<0.05)。结论偏头痛患者有多个脑区参与嗅觉处理, 存在特殊性的嗅觉相关脑网络。     

药物过度使用性头痛患者脑白质结构的变化

目的利用磁共振弥散张量成像技术研究药物过度使用性头痛患者脑白质结构的变化。方法药物过度使用性头痛患者(病例组)及年龄、性别相匹配的同期健康体检者(对照组)各80例,收集一般临床资料,进行颅脑磁共振弥散张量成像(diffusion tensor imaging,DTI)检查,测取部分各向异性(fractional anisotropy,FA)值、表观弥散系数(apparent diffusion coefficient,ADC)值,并结合临床特点进行相关性分析。结果 (1)病例组眶额皮质、前后扣带回皮质、胼胝体压部、右侧内囊前肢FA值较对照组明显降低,差异有统计学意义(P0.05);(2)病例组右侧眶额皮质、左侧额下回皮质及前扣带回皮质ADC值较对照组明显升高,差异有统计学意义(P0.05);(3)病例组双侧眶额部皮质以及右侧内囊后肢FA值与患者头痛病程及发作频率呈负相关;左侧内囊后肢FA值与头痛频率呈负相关;(4)病例组左侧眶额皮质ADC值与患者头痛病程及发作频率呈正相关;右侧眶额皮质以及前扣带回皮质ADC值与患者头痛发作频率呈正相关;后扣带回皮质ADC值与患者头痛病程呈正相关。结论药物过度使用性头痛患者双侧额叶皮质及扣带回皮质存在白质微观结构异常变化,FA值与患者头痛病程及发作频率呈负相关,ADC值则呈正相关。     

单相和双相抑郁障碍患者前扣带回功能连接特征差异观察北大核心CSCD

目的比较单、双相抑郁障碍前扣带回功能连接的差异,探讨前扣带回功能连接与抑郁症状严重程度的关系。方法利用fMRI技术,对符合DSM-Ⅳ诊断标准的30例单相抑郁障碍(unipolar depression)患者(单相抑郁组)、30例双相抑郁障碍(bipolar depression)患者(双相抑郁组)及年龄、性别、受教育程度相匹配的32名对照者(对照组)进行静息态fMRI扫描,以前扣带回为感兴趣区进行功能连接分析,比较组间差异,并对功能连接强度与抑郁症状的严重程度之间的关联进行Pearson相关分析。结果(1)与对照组相比,单相抑郁组左侧前扣带回与左侧三角部额下回(t=3.48)、左侧顶下缘角回(t=3.15)之间的功能连接增强,右侧前扣带回与左侧三角部额下回(t=3.52)之间的功能连接增强;(2)与对照组相比,双相抑郁组左侧前扣带回与右侧颞中回(t=-4.00)之间的功能连接减低,右侧前扣带回与左侧中央后回(t=-3.46)、右侧颞上回(t=-2.86)、右侧颞中回(t=-3.40)之间的功能连接减低;(3)与双相抑郁组相比,单相抑郁组左侧前扣带回与左侧三角部额下回(t=3.58)、右侧三角部额下回(t=4.06)、右侧颞中回(t=3.25)、左侧顶下缘角回(t=3.27)、右侧顶下缘角回(t=3.99)之间的功能连接增强;右侧前扣带回与左侧三角部额下回(t=3.13)、左侧顶下缘角回(t=3.42)、右侧顶下缘角回(t=3.78)之间的功能连接增强(均采用Alphasim校正,P<0.001);(4)Pearson相关分析显示,以上差异脑区功能连接强度与HAMD17总分均无相关性(-0.20.05)。结论静息态下单相抑郁患者前扣带回功能连接增强,双相抑郁患者前扣带回功能连接减弱;单、双相抑郁障碍差异脑区功能连接强度与临床症状无相关性。     

难治性癫痫患者脑网络介数及其异常脑区间功能连接变化研究

目的基于图论的分析方法了解难治性癫痫患者脑功能网络介数属性变化,探讨介数异常脑区间功能连接改变的意义。方法采集难治性癫痫患者及健康被试RS-f MRI数据后,通过Gretna中Network Analysis模块预处理并计算出各脑区的介数值,经统计检验找出介数值有差异脑区;运用REST软件将上述脑区作为ROI两两之间做功能连接,经统计检验后找出脑区间差异的连接。结果与对照组相比,癫痫组介数值升高的脑区有右侧额下回三角部、右侧嗅皮质;介数值下降的脑区有右侧额上回背外侧、左侧额上回眶部、左侧前扣带回、右侧颞上回、右侧颞下回;与健康被试相比,额下回三角部与颞上回之间的连接降低。结论难治性癫痫患者脑功能网络介数属性及异常脑区间的功能连接改变,引起脑区间信息交流的障碍,可能导致癫痫患者认知功能的损伤。     

部分性发作癫痫患者静息状态功能磁共振默认模式网络的功能连接改变

目的 应用静息状态功能磁共振成像(fMRI)探讨部分性发作癫痫患者静息状态下的脑功能改变.方法 对60例部分性发作癫痫患者(患者组)和60名性别、年龄和教育程度匹配的健康对照者(对照组),使用3.0T磁共振采集两组的静息状态下fMRI数据,采用功能连接方法分析计算脑区的默认模式网络的功能连接,利用SPM5软件分析比较患者组和对照组脑功能的差异.结果 患者组的默认模式网络的功能连接主要包括左侧楔前叶/后扣带回和角回、扣带回;对照组的功能连接主要包括左侧楔前叶/后扣带回和右侧角回,双侧内侧额叶和颞叶;患者组的左侧顶下小叶[坐标值(x,y,z):-57,-39,48;t=4.90,P＜0.01]、左侧缘上回[坐标值(x,y,z):-63,- 48,33;t=4.25,P＜0.01]、左侧海马旁回[坐标值(x,y,z):-30,-6,-21;t =4.05,P＜0.01]、左侧颞上回[坐标值(x,y,z):-48,-39,6;t=3.72,P＜0.01],左侧钩回[坐标值(x,y,z):-24,6,- 36;=4.56,P＜0.01]及右侧钩回[坐标值(x,y,z):33,-15,- 36;t=4.00,P＜0.01]的默认模式网络功能连接较对照组降低;未发现功能连接升高的脑区.结论 部分性发作癫痫患者静息状态下脑区的功能连接改变,可能是部分性发作癫痫潜在的病理生理机制.静息状态fMRI能发现常规MRI正常的癫痫患者的广泛脑功能异常,是一种无创的研究癫痫患者脑功能的有效方法.     

首次发病且未用药的成年早发和晚发抑郁症患者脑功能连接差异研究

目的比较成年早发抑郁症(EOD)和成年晚发抑郁症(LOD)患者默认网络(DMN)内部功能连接的差异,探究不同发病年龄的抑郁症患者是否有不同的发病机制。方法选取在昆明医科大学第一附属医院精神科门诊或住院的EOD患者(n=58)和LOD患者(n=62)为研究对象,同期招募年轻健康对照组(n=60)和年老健康对照组(n=52)。对受试者进行静息态功能磁共振扫描,选择左侧楔前叶为种子点,计算该种子点与全脑的功能连接,并比较各组间该种子点的功能连接差异。结果四组之间功能连接具有差异的脑区涉及双侧额叶、颞叶、基底节、枕叶、顶叶及小脑等脑区。EOD组左侧楔前叶与左侧小脑Crus1区、左侧小脑IX区、左侧颞中回、右侧楔前叶、右侧前扣带回、右侧额中回、右侧角回、右侧脑岛、右侧内侧额上回、右侧颞中回的功能连接均高于年轻健康对照组(Z=3. 752 4～5. 867 8,P均0. 05);而左侧楔前叶与左侧额中回、左侧中央旁小叶、右侧缘上回、右侧额上回、右侧颞下回、右侧中央后回、右侧中央前回、右侧枕上回的功能连接均低于年轻健康对照组(Z=-5. 007 6～-3. 797 7,P均0. 05)。LOD组左侧楔前叶与左侧小脑Crus2区、左侧尾状核、左侧颞下回、左侧小脑Crus1区、左侧角回、左侧额中回、右侧额中回、右侧角回、右侧眶额部额中回的功能连接均高于年老健康对照组(Z=4. 122 8～6. 579 4,P均0. 05);与左侧海马旁回、左侧额上回、右侧枕中回、右侧中央前回、右侧内侧额上回、右侧锯状回、右侧颞下回、右侧中央旁小叶、右侧梭状回、右侧后扣带回的功能连接均低于年老健康对照组(Z=-5. 884 0～-3. 617 2,P均0. 05)。EOD组左侧楔前叶与左侧锯状回、左侧小脑IV-VI区、左侧小脑Crus2区的功能连接比LOD组高(Z=4. 087 7、3. 937 4、3. 672 1,P均0. 05);EOD组左侧楔前叶与右侧额中回、右侧眶额部额下回、右侧额上回的功能连接比LOD组低(Z=-4. 274 8、-3. 956 8、-4. 724 3、-3. 663 2,P均0. 05)。结论 DMN内部功能连接增高及额顶网络功能连接降低可能与EOD的发病机制相关,而DMN前部功能连接增高和后部功能连接降低可能与LOD的发病机制相关,不同发病年龄的成年抑郁症患者可能有不同的发病机制。     

矿难后急性重性创伤后应激障碍症状激发和创伤有关短期记忆提取的功能性磁共振成像研究

目的 探讨急性重性创伤后应激障碍(post traumatic stress disorder,PTSD)患者的脑功能及执行记忆功能时的脑反应.方法 采用功能磁共振成像技术,对经历矿难的10例急性重性PTSD患者(PTSD组)和7例非PTSD对照(非PTSD组)执行症状激发任务,并首次采用1项创伤有关的短期记忆提取任务进行记忆功能的测定.结果 症状激发试验中,PTSD组负性图片相比中性图片,左侧后扣带回、双侧尾状核和右侧丘脑等脑区激活增强,右侧扣带回和双侧额中回激活下降;PTSD组相比非PTSD组,右侧前扣带回、左侧额下回、双侧额中回及双侧颞中回等脑区激活下降,左侧海马旁回激活增高.短期记忆提取任务中,PTSD组负性图片相比中性图片,右侧后扣带回和双侧海马存在明显激活;PTSD组相比非PTSD组,右侧额下回、右侧额中回、左侧枕中回等脑区激活下降.记忆提取任务相比症状激发任务,PTSD组右侧海马旁回激活下降.结论 急性重性PTSD患者在急性期已存在部分脑区激活的下降以及记忆功能的减退.     

重性抑郁症脑白质性别差异的初步研究

目的 利用磁共振弥散张量成像技术探讨重性抑郁症患者脑白质纤维是否存在性别差异.方法 24例重性抑郁症患者(男15例,女9例)及30名正常对照(男11名,女19名)均经常规核磁共振(MRI)和DTI扫描,基于像素的全脑分析技术对各组间DTI数据进行比较分析.结果 [1]男性患者左额中回、右颞叶回下、左梭状回、楔前叶及右顶叶回下等区域各向异性值(faraction anistropy, FA)低于男性正常对照(P<0.001);女性患者在右额上回、额叶回下、颞叶回下、左颞上回及右后扣带回等白质区域的FA值低于女性正常对照(P<0.001).[2]女性患者在右顶叶回下、左中央前回、右颞中回及右扣带回白质区域的FA值低于男性患者(P<0.001);女性正常对照仅在左边缘叶下回及左枕叶中回的区域的FA值低于男性正常对照(P<0.001).结论 男女抑郁症患者均存在脑白质异常区域,且两老少间存在差异.     

难治性抑郁症脑局部葡萄糖代谢的初步研究

目的 探索难治性抑郁症的脑局部葡萄糖代谢模式.方法 对符合国际疾病分类标准第10版(ICD.10)抑郁症诊断标准的8例难治性抑郁症患者和8名正常对照进行静息态正电子发射计算机断层/18F-氟代脱氧葡萄糖(PET/FDG)扫描,利用参数统计图(SPM2)方法分析组间脑局部代谢差异.结果 患者组的双侧额中回、左侧眶额皮质、左顶下小叶、左腹侧前扣带回、右侧额下回、右颞是回和颞中回以及双侧背侧前扣带回FDG代谢水平明显低于对照组;而左侧中央前/后回、右侧额内侧回、右颞极、右岛叶以及双侧小脑等脑区代谢水平则明显高于对照组.上述差异均有统计学意义(P<0.005).结论 难治性抑郁症患者存在旁边缘系统代谢增高和皮质代谢降低的交互性改变的异常代谢模式.     

青少年广泛性焦虑障碍患者静息态功能磁共振成像研究

目的:运用局部一致性(ReHo)方法研究首发青少年广泛性焦虑障碍患者的局部自发性脑活动. 方法:对19例首发青少年广泛性焦虑障碍患者及14名年龄、性别与其相匹配的正常对照进行静息态脑功能磁共振成像扫描,通过计算每个给定体素与其最邻近的26个体素之间的肯德尔和谐系数(KCC)来获得全脑的局部一致性(ReHo)图,利用双样本t检验分析两组受试者静息态下局部一致性的差异. 结果:与正常对照相比,青少年广泛性焦虑障碍患者局部一致性降低的脑区包括双侧额中回、枕中回,左侧额上回、颞下回、前扣带回及右侧顶下回、枕下回(P ＜0.005,未校正);局部一致性增高的脑区包括:右侧楔前叶、角回及左侧枕上回(P ＜0.005,未校正). 结论:青少年广泛性焦虑障碍患者静息态脑功能局部一致性存在异常.     

抑郁症患者脑白质变化初步研究

目的：利用能够提示脑白质纤维完整性的磁共振弥散张量成像（DTI）探讨首发和复发重性抑郁症患者脑白质纤维的变化及其差异。方法：20例重性抑郁症患者（首发9例，复发11例）和20名正常对照者均经常规磁共振成像（MRI）平扫，未发现异常者继续进行DTI和结构MRI（3D）扫描，基于像素的全脑分析技术对DTI数据进行分析。结果：与对照组相比较，抑郁症组白质纤维结构在双侧额中回、右顶下小叶及双侧脑岛等区域白质的各向异性值（FA）显著降低（各脑区P均〈0.001，cluster〉30像素）;与首发抑郁症患者相比较，复发抑郁症患者右侧额上回、右顶叶、中央前回、中央后回及右顶下小叶等区域FA值降低更为显著（各脑区P均〈0.001，cluster〉10像素）。结论：重性抑郁症患者存在脑白质异常，抑郁反复发作会导致脑白质损害进一步加重。     

Acupuncture at the Taixi （KI3） acupoint activates cerebral neurons in elderly patients with mild cognitive impairment

Our previous ifndings have demonstrated that acupuncture at the Taixi （KI3） acupoint in healthy youths can activate neurons in cognitive-related cerebral cortex. Here, we investigated whether acupuncture at this acupoint in elderly patients with mild cognitive impairment can also activate neurons in these regions. Resting state and task-related functional magnetic resonance imaging showed that the pinprick senstation of acupuncture at the Taixi acupoint differed signiifcantly between elderly patients with mild cognitive impairment and healthy elderly controls. Results showed that 20 brain regions were activated in both groups of participants, including the bi-lateral anterior cingulate gyrus （Brodmann areas [BA] 32, 24）, left medial frontal cortex （BA 9, 10, 11）, left cuneus （BA 19）, left middle frontal gyrus （BA 11）, left lingual gyrus （BA 18）, right medial frontal gyrus （BA 11）, bilateral inferior frontal gyrus （BA 47）, left superior frontal gyrus （BA11）, right cuneus （BA 19, 18）, right superior temporal gyrus （BA 38）, left subcallosal gyrus （BA 47）, bilateral precuneus （BA 19）, right medial frontal gyrus （BA 10）, right superior frontal （BA 11）, left cingulate gyrus （BA 32）, left precentral gyrus （BA 6）, and right fusiform gyrus （BA 19）. These results suggest that acupuncture at the Taixi acupoint in elderly patients with mild cogni-tive impairment can also activate some brain regions.     

Morphometric Brain Abnormalities in Schizophrenia in a Population-Based Sample: Relationship to Duration of Illness

Biased recruitment and sample selection may cause variability in neuroimaging studies. Epidemiologically principled population-based magnetic resonance imaging (MRI) studies of schizophrenia are very rare. We gathered structural MRI data on 154 subjects from the Northern Finland 1966 Birth Cohort, aged 33–35 (100 controls, 54 schizophrenia patients). Regional differences in density of gray matter, white matter, and cerebrospinal fluid (CSF) were identified between groups using nonparametric statistical analysis, and the relationship of the regional differences to duration of illness was explored. Gray matter reductions were found bilaterally in the cerebellum, thalamus, basal ganglia, middle frontal gyrus, inferior frontal gyrus, precentral gyrus, insula, superior temporal gyrus, fusiform gyrus, parahippocampal gyrus, cuneus, and lingual gyrus; in the left posterior cingulate, superior frontal gyrus, transverse temporal gyrus, and precuneus; and in the right postcentral gyrus. Gray matter excesses were observed bilaterally in the basal ganglia, anterior cingulate, and medial orbitofrontal cortices. There were white matter deficits in an extensive network including inter- and intrahemispheric tracts bilaterally in the frontal, temporal, parietal, and occipital lobes, subcortical structures, cerebellum, and brain stem. CSF excesses were found bilaterally in the lateral ventricles, third ventricle, interhemispheric, and left Sylvian fissure. We replicated the previous findings of structural brain abnormalities in schizophrenia on a general population level. Gray and white matter deficits were associated with duration of illness suggesting either that developmental brain deficits relate to an earlier age of onset or that brain abnormalities in schizophrenia are progressive in nature.     

Two types of mental fatigue affect spontaneous oscillatory brain activities in different ways

Background

Fatigue has a multi-factorial nature. We examined the effects of two types of mental fatigue on spontaneous oscillatory brain activity using magnetoencephalography (MEG).

Methods

Participants were randomly assigned to two groups in a single-blinded, crossover fashion to perform two types of mental fatigue-inducing experiments. Each experiment consisted of a 30-min fatigue-inducing 0- or 2-back test session and two evaluation sessions performed just before and after the fatigue-inducing mental task session.

Results

After the 0-back test, decreased alpha power was indicated in the right angular gyrus and increased levels in the left middle and superior temporal gyrus, left postcentral gyrus, right superior frontal gyrus, left inferior frontal gyrus, and right medial frontal gyrus. After the 2-back test, decreased alpha power was indicated in the right middle and superior frontal gyrus and increased levels in the left inferior parietal and superior parietal lobules, right parahippocampal gyrus, right uncus, left postcentral gyrus, left middle frontal gyrus, and right inferior frontal gyrus. For beta power, increased power following the 0-back test was indicated in the left middle temporal gyrus, left superior frontal gyrus, left cingulate gyrus, and left precentral gyrus. After the 2-back test, decreased power was suggested in the left superior frontal gyrus and increased levels in the left middle temporal gyrus and left inferior parietal lobule. Some of these brain regions might be associated with task performance during the fatigue-inducing trials.

Conclusions

Two types of mental fatigue may produce different alterations of the spontaneous oscillatory MEG activities. Our findings would provide new perspectives on the neural mechanisms underlying mental fatigue.     

年轻人与老年人简单乘法运算之功能磁共振成像研究

目的应用fMRI技术探讨中国青年和老年人群在简单运算任务下脑激活模式及其与行为学之间的关系。方法分别对青年组(19例)和老年组(20例)健康志愿者进行对照任务和简单运算任务下的fMRI检查。结果两组受试者受教育程度(P=0.125)、智力水平(P=0.921),以及完成对照任务(P=0.142)和简单乘法运算任务(P=0.880)之正确率差异无统计学意义,但老年组受试者完成对照任务(P=0.000)和简单乘法运算任务(P=0.005)反应时间明显延长。青年组受试者在任务刺激下可激活右侧缘上回并向顶内沟和颞中上回后部延伸,中央前回和运动前区、前额叶,左侧缘上回并向颞上回后部和角回延伸,顶内沟区域、颞中下回,内侧后扣带回、楔前叶、辅助运动区、海马沟、海马旁回及前额叶内侧;老年组受试者则分别激活右侧缘上回和顶下区域并向颞中上回后部延伸,中央前回和运动前区、前额叶,左侧缘上回和角回并向顶下延伸,中央前回和运动前区、岛叶及前额叶,内侧后扣带回和中央旁小叶、前扣带回及前额叶内侧;两组受试者共激活脑区包括顶下区域、楔前叶、中央前后回和额顶叶网络,以及颞叶、海马旁回、钩回、屏状核和后扣带回等皮质下结构。结论数学事实提取相关网络的主要成分受年龄影响较小,老年人群的任务激活脑区主要向任务相关顶区集中。     

Brain functional changes in facial expression recognition in patients with major depressive disorder before and after antidepressant treatment A functional magnetic resonance imaging study

Functional magnetic resonance imaging was used during emotion recognition to identify changes in functional brain activation in 21 first-episode, treatment-naive major depressive disorder patients before and after antidepressant treatment. Following escitalopram oxalate treatment, patients exhibited decreased activation in bilateral precentral gyrus, bilateral middle frontal gyrus, left middle temporal gyrus, bilateral postcentral gyrus, left cingulate and right parahippocampal gyrus, and increased activation in right superior frontal gyrus, bilateral superior parietal lobule and left occipital gyrus during sad facial expression recognition. After antidepressant treatment, patients also exhibited decreased activation in the bilateral middle frontal gyrus, bilateral cingulate and right parahippocampal gyrus, and increased activation in the right inferior frontal gyrus, left fusiform gyrus and right precuneus during happy facial expression recognition. Our experimental findings indicate that the limbic-cortical network might be a key target region for antidepressant treatment in major depressive disorder.     

Abnormal functional connectivity in patients with vascular cognitive impairment, no dementia: a resting-state functional magnetic resonance imaging study

The functional connectivity (FC) method was used to investigate the changes in the resting state of patients with vascular cognitive impairment, no dementia (VCIND). Resting-state functional magnetic resonance images (fMRIs) were acquired from 16 patients with subcortical ischemic vascular disease (SIVD) who fulfilled the criteria for VCIND, as well as 18 age- and sex-matched subjects with SIVD with no cognitive impairment (control group). Posterior cingulate cortex connectivity was gathered by investigating synchronic low-frequency fMRI signal fluctuations with a temporal correlation method. Compared with the control group, the patients showed FC decrease in the left middle temporal gyrus, the left anterior cingulate/left middle frontal gyrus, the right caudate, the right middle frontal gyrus, and the left medial frontal gyrus/paracentral lobule. There were also some regions that showed increased connectivity. These regions included the right inferior temporal gyrus, the left middle temporal gyrus, the left precentral gyrus, and the left superior parietal lobule. Our findings revealed the change in resting-state patterns of neuronal activity in patients with VCIND. This change may be caused by subcortical white matter lesions that destroyed direct and indirect fiber tract connectivity across the cerebral white matter and influenced the cortical FC and hypoperfusion resulted from small vascular disease. The results of the increased connectivity may be evoked by the compensatory recruitment and plasticity mechanism. Our findings suggest that the simplicity and noninvasiveness of this method makes it a potential tool to help thoroughly understand the pathogenesis of VCIND.     

轻度认知功能障碍患者正电子发射计算机体层摄影术和神经心理学测定的初步研究

目的　探讨轻度认知功能障碍患者脑葡萄糖代谢与神经心理学特点及其相互关系。方法　采用正电子发射体层摄影术 (PET)、简易智能状态测定 (MMSE)、韦克斯勒记忆量表测定 (WMS)和总体衰退量表 (GDS)测定 10例轻度认知功能障碍 (MCI)患者和 10名健康志愿者 (HC)。结果 (1)MCI组MMSE[(2 4.6± 2 2 )分 ]、WMS[(6 9.4± 10 .4)分 ]分值低于HC组 [分别为 (2 8.9± 1.1)分和 (93.1± 9.0 )分 ;P〈0 .0 1];(2 )MCI组左侧眶回、右侧颞叶中回和右侧壳核的局部脑葡萄糖代谢率 (rCMRglc)较HC组低 (P〈0 .0 5～ 0 .0 1) ;(3)将年龄、受教育年限、MMSE、WMS与不同脑区用18F标记的脱氧葡萄糖放射性比值进行相关分析显示 ,与年龄呈负相关 (P〈0 .0 5或P〈0 .0 1)的脑区有 :眶回、左侧额上回、左侧额下回、颞叶中回、颞叶下回、左侧顶叶、左侧中央前回、右侧中央后回、左颞叶内侧皮质、左侧海马回、左侧海马旁回、右侧前扣带回、后扣带回、左侧杏仁核等。与文化程度呈正相关 (P〈0 .0 5或P〈0 .0 1)的脑区有 :左侧颞叶下回、中央前回、左侧中央后回等 ;而右侧壳核则呈负相关。与MMSE呈正相关 (P〈0 .0 5或P〈0 .0 1)的脑区有 :额下回、左侧颞叶上回、颞叶中回、颞叶下回、左侧顶叶、左侧中央前回、中央后回、颞叶内侧皮     

基于核磁共振成像技术的甲状腺功能减退伴焦虑患者的脑功能区研究

目的 探讨甲状腺功能减退伴焦虑患者脑功能区核磁共振成像(Magnetic resonance imaging,MRI)表现。方法 选取本院2018年5月-2019年8月收治的甲状腺功能减退伴焦虑患者30例为观察组,并选取同期体检健康者30例为对照组; 收集2组研究对象的一般资料,并对脑功能区进行功能磁共振成像(Functional magnetic resonance imaging,fMRI)扫描,采用局部一致性(Regional homogeneity,ReHo)值找出基础状态下自发异常脑功能活动区,Speaeman分析异常脑功能区与甲状腺激素水平、神经精神症状的相关性。结果 fMRI扫描显示甲状腺功能减退患者右海马旁回、左侧颞下回、左右前扣带回脑功能区的ReHo值明显高于对照组(0.81±0.02 vs. 0.78±0.04、0.73±0.07 vs. 0.69±0.05、0.89±0.12 vs.0.84±0.09、0.87±0.11 vs. 0.83±0.07)(P<0.05),左侧内额上回ReHo值明显低于对照组(0.77±0.13 vs. 0.72±0.11)(P<0.05); 不同焦虑程度的右海马旁回、左侧颞下回、左前扣带回、右前扣带回、左侧内侧额上回5个异常脑功能区ReHo值相近(P>0.05); 左、右前扣带回ReHo值与游离甲状腺素(Free thyroxine,FT4)水平显著相关(r=-0.398,P=0.023; r=-0.424,P=0.031); 左、右前扣带回ReHo值与焦虑等级显著相关(r=0.425,P=0.533; r=0.027,P=0.017)。结论 海马旁回、颞下回、前扣带回、内侧额上回4个脑功能区可能参与甲状腺功能减退患者引发焦虑症状的脑部生理机制,甲状腺功能减退患者焦虑症状的脑神经反常活动与前扣带回自发异常活动密切相关,可为甲状腺功能减退伴焦虑患者的临床诊疗提供新思路。     

Application of diffusion tensor imaging for detecting structural changes in the brain of schizophrenic patients

Abstract

Objective. Schizophrenia is a severe psychiatric illness. Although magnetic resonance imaging has been widely used for detecting brain structural and functional abnormalities in patients with schizophrenia, the findings are highly inconsistent between reports. This study investigates structural changes in the brains of schizophrenic patients. Methods. The brains of fifty male adults with schizophrenia and fifty age- and gender-matched healthy controls were scanned by diffusion tensor imaging. The differences in fractional anisotropy （FA） values between schizophrenic patients and healthy controls were analyzed. Results. Schizophrenic patients exhibited significantly decreased FA values in the right middle frontal gyrus, right inferior frontal gyrus, right superior temporal gyrus, left sub-temporal gyrus, left middle temporal gyrus, left cingulate gyrus, and left precentral gyrus compared with the control group. We did not find any brain regions with higher FA values in the patient group than in the control group. Conclusion. This study suggested that structural abnormalities in the frontal region of gray matter and white matter are present at the same time in patients with schizophrenia.