多发性硬化（MS）患者静息态视觉网络的脑功能研究

目的评价静息态功能磁共振（rfMRI）方法研究多发性硬化患者视觉网络的价值。方法 34例多发性硬化患者及性别、年龄相匹配的34名健康志愿者均接受静息态功能MRI扫描（采用西门子MAGNRTOM3.0T Trio Tim）,基于Mat-lab2009a平台使用独立成分分析法（independent component analysis,ICA）提取并比较两组视觉网络功能成分的差异,数据统计采用统计参数图（SPM8）软件（双样本t检验）。结果与对照组比较,患者组在左侧楔叶、双侧距状裂、双侧枕上回、左侧楔前叶出现神经元活动增强区。说明患者组静息态视觉网络存在一定的代偿。结论 rfMRI是研究脑功能网络的一种有效办法。     

静息态脑功能低频振幅对有氧训练后AD患者功能改善评估的研究

目的 探讨静息态脑功能低频振幅(ALFF)的变化评估有氧运动后阿尔茨海默病(A D )患者功能改善的价值.方法 将42例A D患者随机均分为训练组和对照组.训练组采用踩脚踏车或以跑步机运动为有氧训练项目 ,以强度为50%-70% 最大运动能力作为训练标准 ,每次训练持续60-90 min(中途休息10 min);共训练12周 ,每周训练3次.检测训练前和12周训练后的 ALFF和简易精神状态检查表(MMSE)评分.结果 训练后 ,训练组MMSE评分和 ALFF值较训练前增高(P＜0 .05);训练组前后两次ALFF差值大于对照组(P＜0 .05).ALFF值与MMSE评分无明显相关性.结论 ALFF可以作为AD患者有氧训练有效性评判的辅助指标.     

低频振幅fMRI在评价精神分裂症患者静息状态下脑功能活动中的应用探讨

目的探讨在评价精神分裂症患者静息状态下脑功能活动中应用低频振幅功能磁共振成像(f MRI)的价值。方法分别选取首发未用药精神分裂症及健康志愿者各40例,将前者记为疾病组,将后者记为健康组。所有受试对象均在静息状态下采用f MRI对其脑功能活性进行测定,对比2组脑功能差异,并采用统计学检验。结果健康组检验结果显示以双侧后扣带回/楔前叶为中心的脑区域ALFF数值显著增高(P<0.05);疾病组检验结果显示上述部分区域的ALFF值显著增高(P<0.05),且前者ALFF值显著增高的区域范围明显比后者广泛。2组双样本t检验显示疾病组ALFF数值增高存在显著性差异的区域有右侧枕叶、右侧胼胝体压部、左侧小脑后叶、左侧楔前叶以及额上回区域(P<0.05),且ALFF数值降低存在显著性差异的区域有左侧楔前叶与左右侧中央后回(P<0.05)。结论采用低频振幅f MRI对精神分裂症患者静息状态下脑功能活动进行检查能为病情评估提供丰富有用的参考信息。     

早发精神分裂症静息态脑功能局部一致性研究

目的通过对早发未用药精神分裂症静息态功能磁共振局部一致性的研究,探索该病存在功能异常的脑区。方法分别对20例早发未用药精神分裂症患者与20名健康对照进行全脑静息态功能磁共振扫描,计算局部一致性值。结果与对照组相比,患者组右侧额中回,右侧额上回ReHo值增高(P<0.05,Al-phaSim校正)。结论静息状态下,早发精神分裂症存在额叶功能的异常,额叶损害可能是精神分裂症较稳定的生物标记物。     

颞叶内侧癫痫并抑郁病人脑功能连接密度的静息态功能磁共振成像研究

目的 探讨颞叶内侧癫痫伴抑郁（MTLEWD）病人在静息态功能磁共振成像（rs-fMRI）中功能活动异常的脑区的特点。方法 纳入2021年1—12月在海南医学院第一附属医院神经内科门诊符合国际抗癫痫联盟（ILAE）诊断分类标准的颞叶内侧癫痫病人,根据HAMD评分将病人分为MTLEWD组和颞叶内侧癫痫不伴抑郁组（MTLE组）,同时纳入与病人性别、年龄相匹配的对照组。使用GE Discovery MR7503.0T设备根据预先设定参数行磁共振扫描,获取静息态功能磁共振数据。采用SPSS 22.0统计分析软件对一般人口学资料进行分析。基于MATLAB 2018平台采用DPABI软件对磁共振数据进行预处理,使用功能连接密度（FCD）分析指标对三组被试者行ANOVA分析差异有统计学意义的脑区,然后行组间两样本的t检验,根据高斯随机场（GRF）理论满足体素显著性<0.001、连续体素数量≥23,团块显著性<0.05的区域被认为差异有统计学意义。结果 共纳入MTLE组病人20例,MTLEWD组病人21例,对照组25例,三组病人一般资料（年龄、性别）差异无统计学意义（P>0.05）。三...     

抑郁症患者脑局部一致性的静息态磁共振研究

目的应用静态功能MR探讨抑郁症患者静息态脑部局部一致性异常。方法对12例重症抑郁症患者及12例年龄、性别及教育程度匹配正常对照组进行静息态功能磁共振成像（resting-fMRI）,所得数据转换后应用局部一致性（ReHo）分析,然后进行基于体素的组间比较,比较两组静息态脑功能的差异（t检验）。结果与健康组比较,抑郁组ReHo减低的脑区有：右脑顶下小叶,右脑海马回,右后扣带回,左枕叶舌回,左小脑前叶,左尾状核,左豆状核,左屏状核。抑郁组ReHo增高的脑区有：右前额叶,左胼胝体,右豆状核-壳核,右屏状核,右小脑后叶小脑扁桃体,右小脑后叶下半月小叶。结论静息态功能磁共振成像可以反映抑郁症患者脑部功能区局部一致性改变。     

精神分裂症患者与正常对照脑功能检查对比研究

目的探讨精神分裂症患者与正常人脑功能检查结果究竟有何不同。方法对符合《国际疾病分类（第10版）》精神分裂症诊断标准的80例患者给予脑功能检查,对同期52例正常对照组也进行脑功能检查,比较两组检查结果,分析两组脑神经递质差异。结果精神分裂症组与正常对照组相比：GABA及Glu递质功率差异有统计学意义（t=－1．991,P=0．049;t=－2．228,P=0．028）,Glu递质相对功率差异有统计学意义（t=－2．115,P=0．036）,递质总功率差异有统计学意义（t=--2．631,P=0．010）。结论精神分裂症患者Glu递质功率、递质相对功率及总功率均高于正常对照组,提示精神分裂症患者大脑递质功能存在异常。     

对精神分裂症患者一级亲属个性与心理状态的调查和干预

目的：对精神分裂症患者一级亲属个性与心理状态进行调查,对问题家属进行干预,目的在于改善患者家庭成员间的关系,促进家属自我意识完善、人格完善,为患者实现良好的社会接触,尽快恢复疾病提供依据和参考。方法300例精神分裂症患者一级亲属,均给予艾森克人格问卷(EPQ)人格量表及症状(精神症状)自评量表(SCL-90)检测,对检测结果提示存在问题的精神分裂症患者一级亲属给予精神卫生知识宣讲和家庭干预,改善其不良认知。比对干预前后精神分裂症患者一级亲属两种自评量表结果变化情况。结果①干预前300例患者家属除L量表为(7.6±1.5)分,位于标准值以下,其余三项量表评分均超过其标准值,存在人格外向、强烈情绪反应及神经质情况。给予家庭干预及疾病宣讲后,除L量表外,300例患者家属各量表评分均较干预前明显改善(P<0.05);②干预前后,患者家属除躯体化、恐怖、偏执、精神病性四项内容无明显变化外,其余各指标均较干预前明显降低(P<0.05)。结论对存在不良认知或异常心理状态的精神分裂症患者一级亲属给予精神卫生知识宣讲会、积极有效的家庭干预等,可改善其不良情绪,提高认知水平,降低焦虑、抑郁等情绪困扰,利于生活质量的提升,值得临床推广。     

首次住院精神分裂症患者脑功能与脑电图检测的对照研究

目的观察A620脑功能与脑电图检测首次精神分裂症患者的敏感性。方法对44例首次住院精神分裂症患者分别进行A620脑功能与脑电图检测，并作对照研究。结果A620脑功能检测阳性率为86．3％，脑电图检测阳性率为59．1％，两种方法差异有统计学意义（P〈0．01）。结论首次住院精神分裂症患者86％以上具有大脑功能比例失调，敏感性高于脑电图检测。     

弓形虫抗体阳性精神分裂症一级亲属免疫球蛋白研究

目的:了解弓形虫抗体阳性精神分裂症一级亲属免疫球蛋白的水平与正常人有无差异。方法:用速率散射比浊法检测弓形虫抗体阳性精神分裂症一级亲属免疫球蛋白(IgG、IgM)指标,并与弓形虫抗体阴性精神分裂症一级亲属、正常对照组进行比较。结果:弓形虫抗体阳性精神分裂症一级亲属免疫球蛋白明显高于两个对照组。结论:弓形虫感染可能是一种独立的发病因素,至少是一种诱发因素。     

Assessing subjective sleep reports in the first-degree relatives of antidepressant-treated depressed outpatients

This study sought to investigate whether first-degree relatives of depressed patients report, and react to, sleep perceptions in the same way as the depressed group. Our previous research suggested that depressed individuals may experience greater sleep 'distress' than healthy individuals; we wished to explore whether this was also apparent in their nearest relatives. A sample was recruited of 18 antidepressant-treated patients with a current DSM-IV diagnosis of major depressive disorder, 18 healthy controls, and a group of 10 first-degree relatives for each study group. In accordance with previous findings, poorer sleep perceptions corresponded with poorer life-quality and mood perceptions, and depressed individuals reported poorer sleep perceptions and poorer life-quality/mood perceptions than controls. Additionally, there was evidence of similar sleep reporting between depressed patients and their relatives, and for a difference between these relatives and other non-depressed groups. There was a non-significant trend for depressed patients, and their relatives, to report total sleep time in the same manner as each other, and differently to other non-depressed groups. Reports of poor sleep may be associated with reports of poor mood in depression, but in non-depressed individuals the association may be with a feeling of weariness.     

综合性心理干预对抑郁症住院患者一级亲属心理健康状况的影响

目的 探讨综合性心理干预对抑郁症住院患者一级亲属心理健康状况的影响作用.方法 纳入2014年6月至2015年12月于石家庄市第八医院住院的抑郁症患者一级亲属300例,采用随机数字表法将一级亲属分为干预组和非干预组,每组均为150例,对干预组进行为期8周的综合性心理干预,非干预组仅给予病情告知,采用症状自评量表(symptom check list-90,SCL-90)在心理干预前后分别对两组的心理状况进行前瞻性研究.结果 在综合性心理干预前,干预组人际关系敏感因子(1.78±0.64)分、恐怖因子(1.26±0.43)分、总分(136.77±18.69)分;非干预组分别是(1.79±0.59)分、(1.25±0.44)分、(134.63±17.54)分,两组比较差异无统计学意义(t=0.141,0.200,1.018,P>0.05).在综合心理干预后,干预组人际关系敏感因子(1.60±0.61)分、恐怖因子(1.12±0.36)分、总分(127.72±15.20)分,非干预组分别为(1.78±0.70)分、(1.27±0.32)分、(135.16±18.16)分,两组比较差异有统计学意义(t=2.368,P<0.05;t=3.846,P<0.01;t=3.826,P<0.01).其他各因子在干预前后,两组均差异无统计学意义(P>0.05).结论 综合性心理干预对抑郁症住院患者一级亲属心理状况具有明显影响,对缓解其负面情绪具有重要意义.     

Decreased regional activity of default-mode network in unaffected siblings of schizophrenia patients at rest

Dysconnectivity hypothesis posits that abnormal resting-state connectivity within the default-mode network (DMN) acts as a key role in schizophrenia. However, little is known about the regional alterations of the DMN in unaffected siblings of schizophrenia patients. Unaffected siblings have a unique advantage in neuroimaging studies independent of clinical and treatment issues that complicate studies on patients themselves. In the present study, we used fractional amplitude of low-frequency fluctuation (fALFF) to investigate regional alterations of the DMN in unaffected siblings of schizophrenia patients at rest. Forty-six unaffected siblings of schizophrenia patients and 50 age-, sex-, and education-matched healthy controls underwent a resting-state functional magnetic resonance imaging (fMRI). The fALFF and independent component analysis (ICA) approaches were used to analyze the data. The unaffected siblings of schizophrenia patients had lower fALFF than the controls in the left inferior temporal gyrus (ITG). No significantly increased fALFF was found in any brain regions in the siblings compared to that in the controls. Further receiver operating characteristic (ROC) curve and support vector machine (SVM) analyses showed that the fALFF values of the left ITG could be utilized to separate the siblings from the controls. Our results first suggest that there is decreased regional activity of the DMN in unaffected siblings of schizophrenia patients, and provide a clue that decreased regional activity of the left ITG could be applied as a candidate biomarker to identify the siblings from the controls.     

2型糖尿病患者正常糖代谢一级亲属胰岛素抵抗及B细胞功能研究

目的探讨2型糖尿病患者正常糖耐量一级亲属胰岛素敏感性及B细胞功能。方法以糖耐量正常(NGT)一级亲属为观察组,无DM家族史的正常人为对照组,比较两组口服75 g葡萄糖耐量试验(OGTT)中0,120 min血糖,胰岛素,自身稳定型评价-B(HOMA-B)和HOMA-IR。结果正常OGTT情况下,DM一级亲属组血浆空腹血糖、胰岛素和OGTT 120 min血糖、胰岛素,显著高于对照组(P<0.05)。观察组HOMA-B和HOMA-IR显著高于对照组(P<0.01)。结论T2DM患者NGT一级亲属在正常糖耐量情况下,已存在高胰岛素血症和胰岛素抵抗,同时B细胞功能明显改变,胰岛素功能降低和胰岛素抵抗是发生DM的主要机制。     

Ventral Tegmental Area/Midbrain Functional Connectivity and Response to Antipsychotic Medication in Schizophrenia

Medication management in schizophrenia is a lengthy process, as the lack of clinical response can only be confirmed after at least 4 weeks of antipsychotic treatment at a therapeutic dose. Thus, there is a clear need for the discovery of biomarkers that have the potential to accelerate the management of treatment. Using resting-state functional MRI, we examined the functional connectivity of the ventral tegmental area (VTA), the origin of the mesocorticolimbic dopamine projections, in 21 healthy controls and 21 unmedicated patients with schizophrenia at baseline (pre-treatment) and after 1 week of treatment with the antipsychotic drug risperidone (1-week post-treatment). Group-level functional connectivity maps were obtained and group differences in connectivity were assessed on the groups'' participant-level functional connectivity maps. We also examined the relationship between pre-treatment/1-week post-treatment functional connectivity and treatment response. Compared with controls, patients exhibited significantly reduced pre-treatment VTA/midbrain connectivity to multiple cortical and subcortical regions, including the dorsal anterior cingulate cortex (dACC) and thalamus. After 1 week of treatment, VTA/midbrain connectivity to bilateral regions of the thalamus was re-established. Pre-treatment VTA/midbrain connectivity strength to dACC was positively correlated with good response to a 6-week course of risperidone, whereas pre-treatment VTA/midbrain connectivity strength to the default mode network was negatively correlated. Our findings suggest that VTA/midbrain resting-state connectivity may be a useful biomarker for the prediction of treatment response.     

阿立哌唑治疗精神分裂症的开放性临床验证

目的验证阿立哌唑治疗精神分裂症的有效性及安全性。方法用可变剂量阿立哌唑治疗精神分裂症45例,剂量范围5～30mg/d,疗程共8周;以PANSS量表、临床疗效总评量表(CGI)评定疗效;以治疗药物副作用量表(TESS)评定药物不良反应。结果45例中36例完成8周疗程,9例在4周内停止使用。治疗结束时,显效率为64.4%(29/45),其中临床痊愈31.1%(14/45),显著进步33.3%(15/45),好转22.2%(10/45),无变化13.3%(6/45)。阿立哌唑治疗精神分裂症常见不良反应为焦虑、静坐不能、头晕、乏力、视物模糊、震颤等。结论阿立哌唑治疗精神分裂症有效、安全,不良反应少,可作为临床治疗精神分裂症的一种选择。