目的探讨重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)治疗对抑郁症患者脑功能的影响。方法选取35例抑郁症患者(major depressive disorder,MDD)作为MDD组,同时选取32例健康志愿者作为健康对照组,rTMS治疗以左...目的探讨重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)治疗对抑郁症患者脑功能的影响。方法选取35例抑郁症患者(major depressive disorder,MDD)作为MDD组,同时选取32例健康志愿者作为健康对照组,rTMS治疗以左背外侧前额叶为靶点,采集治疗前、后17项汉密尔顿抑郁量表(Hamilton depression rating scale,HAMD-17)和静息态磁共振功能影像数据,比较HAMD-17总分与度中心性(degree centrality,DC)指标变化。结果(1)治疗后MDD患者HAMD-17总分显著低于治疗前(8.27±4.21 vs 20.93±5.16,P<0.001)。(2)影像学结果显示,与健康对照比较,治疗前抑郁症患者左侧额上回(t=-6.235,P<0.001)和右侧额上回(t=-6.988,P<0.001)DC值显著减少,左侧辅助运动皮层(t=6.173,P<0.001)和右侧辅助运动皮层(t=7.588,P<0.001)DC值显著增加。与治疗前比较,治疗后抑郁症患者左侧额上回(t=5.798,P<0.001)和右侧额上回(t=6.405,P<0.001)DC值显著增加,左侧辅助运动皮层(t=-5.367,P<0.001)和右侧辅助运动皮层(t=-6.462,P<0.001)DC值显著减少。结论连续15 d rTMS治疗快速有效缓解抑郁症状,左侧额上回脑功能增强可能是抑郁症状缓解潜在的神经影像机制。展开更多
Common abnormalities within the schizophrenia spectrum may be essential for the pathogenesis of schizophrenia, but additional pathological changes may be required for the development of full-blown schizophrenia. Clari...Common abnormalities within the schizophrenia spectrum may be essential for the pathogenesis of schizophrenia, but additional pathological changes may be required for the development of full-blown schizophrenia. Clarifying the neurobiological similarities and differences between established schizophrenia and a milder form of schizophrenia spectrum disorder would potentially discriminate the pathophysiological mechanisms underlying the core features of the schizophrenia spectrum from those associated with overt psychosis. High-resolution MRIs were acquired from 25 patients with schizotypal disorder, 53 patients with schizophrenia and 59 healthy volunteers matched for age, gender, handedness and parental education. Volumetric measurements of the medial temporal structures and the prefrontal cortex subcomponents were performed using consecutive 1-mm thick coronal slices. Parcellation of the prefrontal cortex into subcomponents was performed according to the intrinsic anatomical landmarks of the frontal sulci/gyri. Compared with the controls, the bilateral volumes of the amygdala and the hippocampus were reduced comparably in the schizotypal and schizophrenia patients. The parahippocampal gyrus volume did not differ significantly between diagnostic groups. Total prefrontal grey matter volumes were smaller bilaterally in the schizophrenia patients than in the controls and the schizotypal patients, whereas the schizotypal patients had larger prefrontal grey matter than the controls in the right hemisphere. In the schizophrenia patients, grey matter volumes of the bilateral superior frontal gyrus, left middle frontal gyrus, bilateral inferior frontal gyrus and bilateral straight gyrus were smaller than those in the controls. The schizophrenia patients also had reduced grey matter volumes in the right superior frontal gyrus, bilateral middle frontal gyrus and right inferior frontal gyrus relative to the schizotypal patients. Compared with the controls, the schizotypal patients had larger volumes of the bilateral middle f展开更多
Objective: To compare brain activity identified by fMRI in subjects with Alzheimer disease (AD) and older healthy controls (HCs) performing an episodic/working memory (EWM) and semantic memory (SM) task. Methods: Nine...Objective: To compare brain activity identified by fMRI in subjects with Alzheimer disease (AD) and older healthy controls (HCs) performing an episodic/working memory (EWM) and semantic memory (SM) task. Methods: Nine AD (mean age 73.6) and 10 HC (mean age 71.8) subjects underwent an fMRI memory paradigm. Tasks comprised 1) baseline (recognizing a single digit presented for 1 second), 2) SM (addition of two single digits, always producing a single digit answer), and 3) EWM (recall of the previous single digit on the stimulus of the next digit). Each condition was presented in 2-minute blocks with a shorter and longer time interval for the first and second minute within blocks. Results: Comparing AD and HC subjects, there were no activated brain regions in common for EWM >SM, but left anterior cingulate (Brodmann area [BA] 24, 0, 31, 4) and left medial frontal lobe gyrus (BA 25, -6, 23, -15) were activated by both groups for SM >EWM. Key differences were that for EWM >SM, HC subjects activated the right parahippocampal gyrus, whereas subjects with AD activated the right superior frontal gyrus and left uncus. Conclusions: Subjects with Alzheimer disease (AD) recruited brain regions for easier episodic/working memory (EWM) tasks used by healthy controls (HCs) for more difficult EWM tasks. AD subjects recruited brain regions for semantic memory tasks used by HCs for more difficult EWM tasks. The authors propose a functional “memory reserve”model of compensatory recruitment according to task difficulty and underlying neuropathology.展开更多
文摘目的探讨重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)治疗对抑郁症患者脑功能的影响。方法选取35例抑郁症患者(major depressive disorder,MDD)作为MDD组,同时选取32例健康志愿者作为健康对照组,rTMS治疗以左背外侧前额叶为靶点,采集治疗前、后17项汉密尔顿抑郁量表(Hamilton depression rating scale,HAMD-17)和静息态磁共振功能影像数据,比较HAMD-17总分与度中心性(degree centrality,DC)指标变化。结果(1)治疗后MDD患者HAMD-17总分显著低于治疗前(8.27±4.21 vs 20.93±5.16,P<0.001)。(2)影像学结果显示,与健康对照比较,治疗前抑郁症患者左侧额上回(t=-6.235,P<0.001)和右侧额上回(t=-6.988,P<0.001)DC值显著减少,左侧辅助运动皮层(t=6.173,P<0.001)和右侧辅助运动皮层(t=7.588,P<0.001)DC值显著增加。与治疗前比较,治疗后抑郁症患者左侧额上回(t=5.798,P<0.001)和右侧额上回(t=6.405,P<0.001)DC值显著增加,左侧辅助运动皮层(t=-5.367,P<0.001)和右侧辅助运动皮层(t=-6.462,P<0.001)DC值显著减少。结论连续15 d rTMS治疗快速有效缓解抑郁症状,左侧额上回脑功能增强可能是抑郁症状缓解潜在的神经影像机制。
文摘Common abnormalities within the schizophrenia spectrum may be essential for the pathogenesis of schizophrenia, but additional pathological changes may be required for the development of full-blown schizophrenia. Clarifying the neurobiological similarities and differences between established schizophrenia and a milder form of schizophrenia spectrum disorder would potentially discriminate the pathophysiological mechanisms underlying the core features of the schizophrenia spectrum from those associated with overt psychosis. High-resolution MRIs were acquired from 25 patients with schizotypal disorder, 53 patients with schizophrenia and 59 healthy volunteers matched for age, gender, handedness and parental education. Volumetric measurements of the medial temporal structures and the prefrontal cortex subcomponents were performed using consecutive 1-mm thick coronal slices. Parcellation of the prefrontal cortex into subcomponents was performed according to the intrinsic anatomical landmarks of the frontal sulci/gyri. Compared with the controls, the bilateral volumes of the amygdala and the hippocampus were reduced comparably in the schizotypal and schizophrenia patients. The parahippocampal gyrus volume did not differ significantly between diagnostic groups. Total prefrontal grey matter volumes were smaller bilaterally in the schizophrenia patients than in the controls and the schizotypal patients, whereas the schizotypal patients had larger prefrontal grey matter than the controls in the right hemisphere. In the schizophrenia patients, grey matter volumes of the bilateral superior frontal gyrus, left middle frontal gyrus, bilateral inferior frontal gyrus and bilateral straight gyrus were smaller than those in the controls. The schizophrenia patients also had reduced grey matter volumes in the right superior frontal gyrus, bilateral middle frontal gyrus and right inferior frontal gyrus relative to the schizotypal patients. Compared with the controls, the schizotypal patients had larger volumes of the bilateral middle f
文摘Objective: To compare brain activity identified by fMRI in subjects with Alzheimer disease (AD) and older healthy controls (HCs) performing an episodic/working memory (EWM) and semantic memory (SM) task. Methods: Nine AD (mean age 73.6) and 10 HC (mean age 71.8) subjects underwent an fMRI memory paradigm. Tasks comprised 1) baseline (recognizing a single digit presented for 1 second), 2) SM (addition of two single digits, always producing a single digit answer), and 3) EWM (recall of the previous single digit on the stimulus of the next digit). Each condition was presented in 2-minute blocks with a shorter and longer time interval for the first and second minute within blocks. Results: Comparing AD and HC subjects, there were no activated brain regions in common for EWM >SM, but left anterior cingulate (Brodmann area [BA] 24, 0, 31, 4) and left medial frontal lobe gyrus (BA 25, -6, 23, -15) were activated by both groups for SM >EWM. Key differences were that for EWM >SM, HC subjects activated the right parahippocampal gyrus, whereas subjects with AD activated the right superior frontal gyrus and left uncus. Conclusions: Subjects with Alzheimer disease (AD) recruited brain regions for easier episodic/working memory (EWM) tasks used by healthy controls (HCs) for more difficult EWM tasks. AD subjects recruited brain regions for semantic memory tasks used by HCs for more difficult EWM tasks. The authors propose a functional “memory reserve”model of compensatory recruitment according to task difficulty and underlying neuropathology.
