摘要
目的 利用血氧水平依赖性(blood oxygenation level-dependent,BOLD)功能磁共振成像(functional magnetic resonance imaging,fMRI)技术探讨首发精神分裂症患者治疗前后认知功能激发图像的特点。方法 13例首发精神分裂症患者入组,用利培酮或氯丙嗪治疗后9例患者复查fMRI。以词语流畅性作业(verbal fluency task,VF)作为任务,采用Block设计,用梯度回波-平面回波成像(GRE-EPI)序列采集数据,经工作站处理后获功能图像。结果 (1)VF激活受试者的额叶(前额叶)、顶叶及颞叶皮层;(2)复查的9例受试者中,7例激活增强,2例激活减弱;(3)治疗后激活增强的7例受试者的双侧额上、中、下回激活有增加趋势,而双侧颞上、中、下回激活有减少趋势(P>0.05);但左额叶背外侧面治疗后的激活明显强于治疗前(P=0.032)。结论 BOLD-fMRI可用于研究人脑的高级认知功能。首发精神分裂症患者治疗前后脑功能图像有明显变化,提示认知缺陷症状是可以治疗的。
Objectives: To investigate the characteristics and to compare the difference of brain images activated with cognition task before and after drug treatment , by using blood oxygenatin level dependent functional magnetic resonance imaging (BLOD-fMRI) in patients with first-episode schizophrenia. Method: 13 drug naive schizophrenic patients were enrolled , fMRI were conducted in 9 of them before and after treatment (with chlorpromazine or risperidone). A block-design paradigm with 6 blocks was applied and the whole brain fMRI were collected as they performed a verbal fluency task (VF). The data of acti-vaton and rest images were reconstructed with an offline workstation and the activation map was obtained. Results: (1)Areas showing activation changes included bilateral prefrontal, parietal and temporal cortices. (2)After the treatment, significantly increased responses were seen in 7 of the 9 subjects who had finished the second examination, and 2 of them showed decreased responses. (3)In the 7 post-treatment patients showing increased responses, compared with the pre-treatment, the post-treatment signal intensity in bilateral superior frontal gyrus, middle frontal gyrus and inferior frontal gyrus increased, and the signal intensity in bilateral superior temporal gyrus, middle temporal gyrus and inferior temporal gyrus decreased (P>0.05); however the post-treatment signal intensity in the left dorsolateral frontal cortex was significantly greater than the pre treatment signal intensity(P=0.032). Conclusion: The BLOD-fMRI can be used to investigate the advanced cognitive function in human. The activation map of verbal fluency task in first-episode drug-naive schizophrenic patients is significantly different between the pre-and post-treatment. This result suggests that cognitive deficits in schizophrenic patients could be improved after treatment.
出处
《上海精神医学》
北大核心
2002年第4期193-197,共5页
Shanghai Archives of Psychiatry
基金
杨森科学研究基金
