摘要
目的探讨急慢性创伤对失去独生子女所致创伤后应激障碍(post-traumatic stress disorder,PTSD)患者静息态脑功能度中心度(degree centrality,DC)的影响。方法回顾性纳入51例失独所致PTSD父母,按失独原因分为子女死于突发事件的PTSD父母35例(急性失独所致PTSD组)及子女死于疾病等慢性因素的PTSD父母16例(慢性失独所致PTSD组),另招募50名当地成年人作为健康对照(healthy control,HC)组。采用临床用PTSD诊断量表(clinician administered PTSD scale,CAPS)评估受试者临床症状的严重程度。采集所有受试者静息态功能MRI数据并计算DC值。使用SPSS 22.0软件进行统计分析。采用协方差分析比较三组间DC值的差异,采用post-hoc分析比较任意两组间DC值的差异;并将显著差异脑区的DC值与CAPS总得分及各子项得分进行相关分析。结果三组间DC值差异脑区为右侧颞下回(MNI:x,y,z=66,-27,-21)、右侧颞极(MNI:x,y,z=54,15,-9)、右侧眶部额下回(MNI:x,y,z=42,21,-15)、双侧内侧额上回(MNI:左x,y,z=-3,60,18;右x,y,z=6,63,12)、左侧顶下缘角回(MNI:x,y,z=-45,-36,51)及左侧中央后回(MNI:x,y,z=-45,-33,51)。与HC组相比,急性与慢性失独所致PTSD组DC值升高的脑区均为右侧颞下回(MNI:急性x,y,z=63,-27,-21;慢性x,y,z=63,-21,-27),急性失独所致PTSD组DC值降低的脑区为右侧颞极(MNI:x,y,z=45,21,-15)及右侧眶部额下回(MNI:x,y,z=48,24,-12),慢性失独所致PTSD组DC值降低的脑区为左侧顶下缘角回(MNI:x,y,z=-45,-36,51)及左侧中央后回(MNI:x,y,z=-45,-33,51)。与慢性失独所致PTSD组相比,急性失独所致PTSD组DC值升高的脑区为左侧顶下缘角回(MNI:x,y,z=-33,-39,42)及左侧中央后回(MNI:x,y,z=-45,-33,51),DC值降低的脑区为右侧颞极(MNI:x,y,z=51,12,-9)、右侧眶部额下回(MNI:x,y,z=42,21,-15)及双侧内侧额上回(MNI:左x,y,z=0,57,15;右x,y,z=3,57,15)。慢性失独所致PTSD组左侧中央后回DC值与CAPS中C1(回避创伤相关想法感受)得分呈显著�
Objective To investigate the effects and significance of acute and chronic trauma on brain degree centrality(DC)in patients with post-traumatic stress disorder(PTSD)who lost their only child at resting state.Methods Retrospectively,the study enrolled a total of 51 parents with PTSD,including 35 PTSD parents whose children was lost in emergencies(acute bereaved PTSD group)and 16 PTSD parents whose children was lost of chronic causes such as diseases(chronic bereaved PTSD group).Fifty local adults were also included as healthy controls(HC group).The clinical administered PTSD scale(CAPS)was used to evaluate the severity of the subjects'clinical symptoms.Resting-state functional magnetic resonance imaging(fMRI)data of all subjects were collected and DC values were calculated.SPSS 22.0 software was used for statistical analysis.Covariance analysis was performed among three groups,while post hoc was performed between any two groups.What's more,correlation analyses were utilized between abnormal brain regions and the scores of CAPS.Results Significant group effects were found in multiple regions,including the right inferior temporal gyrus(MNI:x,y,z=66,-27,-21),right temporal pole(MNI:x,y,z=54,15,-9),right orbital inferior frontal gyrus(MNI:x,y,z=42,21,-15),bilateral medial superior frontal gyri(MNI:right x,y,z=6,63,12;left x,y,z=-3,60,18),left inferior parietal angular gyrus(MNI:x,y,z=-45,-36,51)and left postcentral gyrus(MNI:x,y,z=-45,-33,51).Compared with HC group,the DC of two patient groups increased in the right inferior temporal gyrus(MNI:acute x,y,z=63,-27,-21;chronic x,y,z=63,-21,-27);the DC of acute bereaved PTSD group decreased in the right temporal pole(MNI:x,y,z=45,21,-15)and the right orbital inferior frontal gyrus(MNI:x,y,z=48,24,-12),while the DC of chronic bereaved PTSD group decreased in the left inferior parietal angular gyrus(MNI:x,y,z=-45,-36,51)and left postcentral gyrus(MNI:x,y,z=-45,-33,51).Compared with chronic bereaved PTSD group,the DC of acute bereaved PTSD group increased in the left inferio
作者
刘波
罗一烽
戚荣丰
葛继元
戴欢欢
兰青悦
张丽
陈峰
曹志宏
李凌江
卢光明
Liu Bo;Luo Yifeng;Qi Rongfeng;Ge Jiyuan;Dai Huanhuan;Lan Qingyue;Zhang Li;Chen Feng;Cao Zhihong;Li Lingjiang;Lu Guangming(Department of Radiology,the Affiliated Yixing Hospital of Jiangsu University,Yixing 214200,China;Department of Medical Imaging,Jinling Hospital,Medical School of Nanjing University,Nanjing 210002,China;National Clinical Research Center for Mental Disorder(the Second Xiangya Hospital of Central South University),Changsha 410011,China;Department of Radiology,Hainan Provincial People’s Hospital,Haikou 570311,China)
出处
《中华行为医学与脑科学杂志》
CAS
CSCD
北大核心
2022年第6期506-512,共7页
Chinese Journal of Behavioral Medicine and Brain Science
基金
国家自然科学基金(81801678,81301209,82171518,81971602)
江苏省自然科学基金青年项目(BK20170223)
湖南省自然科学基金青年项目(2020JJ5844)
无锡市卫健委重大项目(Z201908)
无锡市中青年拔尖人才项目(BJ2020109)
无锡市卫健委转化医学专项(ZH202108)。
关键词
失独
急性创伤
慢性创伤
创伤后应激障碍
度中心度
功能磁共振成像
People who lost their only child
Acute trauma
Chronic trauma
Post-traumatic stress disorder
Degree centrality
Functional magnetic resonance imaging
