摘要
目的 采用基于体素的形态学测量-自建模板及微分同胚图像融合（VBM-DARTEL）算法,对比近期发病儿童创伤后应激障碍（PTSD）患者和创伤暴露的健康对照（TEC）的脑灰质结构差异,并分析差异脑区的体积与患者症状严重程度的相关性.方法 采集2008年5月12日汶川大地震后7-15个月的幸存儿童的高分辨率三维T1WI图像,PTSD患者28例、TEC 26例.采用Matlab 2012b工作平台下SPM8软件的VBM-DARTEL工具包进行图像分析,采用一般线性模型应用两样本t检验比较两组被试的灰质体积差异（P〈0.005,AlphaSim矫正）,用SPSS分析差异脑区的体积与患者临床创伤应激障碍诊断量表（CAPS）评分及PTSD自评量表（PCL）评分的相关性.结果 与TEC比较,儿童PTSD患者左侧额下回、辅助运动区、楔前叶和双侧小脑半球灰质体积下降（核团大小分别为230、118、134、298、325个体素,P〈0.005）.左侧楔前叶和辅助运动区灰质体积与CAPS评分呈正相关（r值分别为0.402、0.410,P值均〈0.05）,左侧辅助运动区灰质体积与PCL评分呈正相关（r=0.383,P=0.049）.结论 近期发病儿童PTSD患者脑灰质结构改变以萎缩为主.双侧小脑的灰质萎缩可能是儿童PTSD患者与成人PTSD患者不同的脑结构特征.
Objective To compare brain structure differences between recent-onset pediatric posttraumatic stress disorder（PTSD） patients and trauma-exposed controls without PTSD（TEC） using voxel-based morphometry（VBM）-diffeomorphic anatomical registration through exponentiated lie algebra （DARTEL） algorithm, and evaluate the relationship between volume of altered brain areas and symptom severity. Methods High-resolution 3-dimensional T1WI images were obtained from 28 first-episode treatment-naive pediatric PTSD patients group and 26 age and gender-matched TEC group within 7-15 months after a major earthquake. With the General Linear Model（GLM）, gray matter volume（GMV） was compared between the two groups using VBM-DARTEL algorithm of SPM8 software running in MatLab 2012b. The statistical map cluster level had a threshold of P〈0.005（Alphasim corrected, voxels〉113）. In regions with significant group differences, the relationships between volumes of altered structures and clinician-administered PTSD scale（CAPS） and PTSD checklist（PCL） scores in patients were evaluated with age as covariates. Results Compared to TEC, pediatric PTSD patients showed GMV reduction in the left inferior frontal gyrus（IFG）, precuneus, supplementary motor area（SMA）, and bilateral cerebellum（voxel size=230, 118, 134, 298, 325, P〈0.005）. Correlation analyses showed that GMV of the left precuneus and SMA were positively correlated with CAPS scores in PTSD patients group, respectively（r=0.402, P=0.037;r=0.41, P=0.034）. In addition, gray matter volume of the left SMA was positively correlated with PCL scores in PTSD group（r=0.383, P=0.049）. Conclusions The characteristics of brain in recent-onset pediatric PTSD patients are mainly atrophy in some gray matter regions compared with TEC. Gray matter reduction in cerebellum may be the unique structural feature in pediatric PTSD.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2017年第3期210-213,共4页
Chinese Journal of Radiology
关键词
应激障碍
创伤后
磁共振成像
脑
Stress disorders
post-traumatic
Magnetic resonance imaging
Brain
