正常人和精神分裂症患者脑灰质体积分析的性别效应

目的:通过比较男性和女性正常人、男性和女性精神分裂症患者之间的脑灰质体积差异,探讨脑结构分析中的性别效应。方法:采集60例正常人(30例男性)和96例精神分裂症患者(48例男性)的高分辨率三维脑结构磁共振图像,运用基于体素的形态测量法(VBM)进行分析,获得每一个体的脑灰质体积图像。采用两样本t检验分别比较男性和女性正常人,男性和女性精神分裂症患者之间的脑灰质体积差异。结果:与女性正常人相比,男性正常人左侧的颞中回和额中回、右侧的边缘叶和颞中回的灰质体积较大(P<0.001),而左侧尾状核和右侧海马的灰质体积较小(P<0.001)。与女性精神分裂症患者相比,男性患者双侧的颞下回和海马、左侧的颞上回和颞中回的灰质体积较大(P<0.001),而未发现灰质体积较小的脑区。结论:性别效应是影响正常人或精神分裂症患者脑结构分析的重要因素。     

遭受多重侵害高职高专女生静息态脑功能局部一致性的研究

目的:探讨遭受多重侵害的高职高专女生静息态脑功能磁共振特点。方法:15名遭受多重侵害无创伤后应激症状被试(PV无PTSS组)、15名多重侵害有创伤后应激症状被试(PV有PTSS组)和15名正常对照接受静息态脑功能扫描。采用SPM8和静息态功能磁共振数据处理工具包分别进行数据预处理和ReHo分析。结果:静息状态下,与对照组相比,PV无PTSS组左侧额下回、左右额内侧回、右侧中央后回、左侧梭状回、左右海马旁回、右侧扣带回、左右豆状核和右侧岛叶的ReHo值降低;左右额上回、左右额中回、左右额下回、左右顶下小叶、左右楔前叶、左右颞上回、左侧颞横回、左右颞中回、右侧舌回和右侧扣带后回的ReHo值升高。与PV有PTSS组相比,PV无PTSS组在右侧额中回和额下回、左侧楔前叶、左侧舌回、左右海马旁回、左侧扣带回和左侧豆状核ReHo值降低;在左右额上回、左右额中回、左侧额内侧回、右侧中央后回、左侧缘上回、左右顶下小叶、左侧梭状回和左侧尾状核ReHo值升高。结论:遭受多重侵害但无创伤后应激症状的高职高专女生在静息状态下脑默认网络以及岛叶、基底神经节、海马旁回存在局部一致性信号异常,这些脑区异常可能为遭受多重侵害导致精神障碍的发病机制提供重要线索。     

精神分裂症及其健康同胞脑灰质体积异常的研究

目的:研究精神分裂症及其健康同胞的脑灰质体积的异常,为寻找精神分裂症大脑灰质异常内表型提供新的线索。方法:对27例精神分裂症、26例精神分裂症健康同胞以及27例年龄、性别及教育年限相匹配的健康对照进行结构磁共振扫描。运用基于体素的形态学分析方法比较各组的全脑灰质体积的差异。结果:与健康对照相比,健康同胞存在左侧枕中回、左侧楔前叶以及右侧丘脑的体积增大,精神分裂症存在左侧颞中回,左侧额上回,双侧颞下回的灰质体积下降以及右侧丘脑体积的增大;与其健康同胞相比,精神分裂症存在左侧额上回、双侧颞下回的灰质体积减小。其中,左侧额上回的灰质损失与精神分裂症的阳性症状总分以及阳性和阴性症状量表总分呈显著相关。结论:研究中发现精神分裂症患者主要表现为脑灰质体积下降,而精神分裂症健康同胞则存在脑灰质体积增大。健康同胞的脑灰质体积增大可能是使其免于罹患精神分裂症的代偿性改变,这些异常的改变可能反映了健康同胞对其遗传易感性相关的脑区灰质异常的代偿性保护作用。     

多发性硬化和视神经脊髓炎的脑灰质结构分析

目的 利用基于体素的形态学测量(VBM)和基于皮层的脑形态学测量(SBM)方法对多发性硬化(MS)和视神经脊髓炎(NMO)患者脑灰质体积及皮层厚度进行比较分析,探讨这两种疾病的脑灰质结构变化的差异。方法 对21例MS患者,16例NMO患者以及19例健康对照者行磁共振常规序列扫描,基于Matlab2014a平台的统计参数工具SPM12以及SPM12下的小工具CAT12,对VBM和SBM方法处理的数据进行分析。结果 MS组与正常对照(NC)组相比,经高斯随机场(GRF)校正后,MS组在左侧枕上回、左侧楔叶、左侧距状皮质、左侧楔前叶、左侧中央后回、左侧中央旁小叶、右侧楔叶、左侧额中回、左侧额上回和左侧额内侧回灰质体积显著性减少(P<0.05);经族系错误(FWE)法校正后,MS组在左侧中央旁小叶、左侧额上回和左侧楔前叶皮层厚度显著性减少(P<0.05)。NMO组与NC组相比,经GRF校正后,NMO组在左侧中央后回、左侧中央前回、左侧顶下小叶、右侧中央前回和右侧额中回灰质体积显著性增加(P<0.05);NMO组在左侧枕中回、左侧枕上回、左侧颞下回、右侧枕中回、左侧额上回眶部、...     

基于局部一致性方法的广泛性焦虑障碍患者静息态功能磁共振成像

目的:探讨广泛性焦虑障碍(GAD)患者静息态局部脑功能的改变。方法:对17例GAD患者和19例性别、年龄相匹配的健康对照组进行静息态功能磁共振数据对比,运用局部一致性(Re Ho)分析方法,获得GAD患者局部一致性异常的脑区。结果:GAD患者静息态下Re Ho值升高的脑区有左侧颞中回、左侧额下回眶部、左侧背外侧额上回、右侧额中回、右侧顶下缘角回、右侧额下回三角部;Re Ho值降低的脑区有左侧楔叶、右侧舌回、右侧中央前回。以上升高或降低的Re Ho值与健康对照组相比有显著性差异(P0.05)。结论:GAD患者静息态下多个脑区Re Ho值存在异常。     

静息态下低频振幅与功能连接异常可识别重性抑郁症

目的:考察静息状态下异常的低频振幅(Amplitude of Low Frequency Fluctuations, ALFF)与功能连接(Functional Connectivity, FC)能否识别出重性抑郁症(Major Depressive Disorder, MDD),并作为MDD可能的神经生物学标记。方法:35名MDD患者与33名对照组被试完成了结构磁共振与静息态功能磁共振的扫描,并完成流调中心用抑郁量表与状态-特质焦虑量表。比较ALFF与FC的组间差异,采用机器学习算法进行特征挑选、建模与分类,并计算支持向量机分类边际值与抑郁得分的相关程度。结果:与对照组相比,MDD组右侧脑岛的ALFF显著增加,额上回与左侧额下回的ALFF显著降低,右侧脑岛至同侧前扣带回的FC显著增加,额上回至双侧梭状回与右侧楔前叶的FC显著降低。脑岛、额上回与额下回的ALFF异常、额上回至左侧梭状回的FC异常可以有效识别MDD,且MDD组的SVM分类边际值与其抑郁症状严重程度呈显著正相关。结论:在静息状态下,MDD患者的ALFF与FC存在异常,且该异常模式可作为识别MDD的候选神经生物学标记。     

首发重度抑郁障碍患者大脑皮质曲率的变化

目的:本研究旨在探索首发重度抑郁障碍患者大脑皮质平均曲率的异常特征。方法:运用基于皮层表面的形态学方法分析首发重度抑郁障碍患者皮质曲率异常特征,入组对象为41例首发抑郁症患者和52例健康对照。结果:与健康对照比较,患者的左侧枕叶外侧、梭状回、额中回上部、中央后回、岛回以及右侧顶下小叶、舌回、颞中回、距状旁回的皮质曲率显著大于健康对照,而患者右侧颞上沟后部的皮质曲率显著小于健康对照。结论:广泛增加的皮质曲率反映出大脑灰质减少可能是重度抑郁障碍的神经病理学特征,并且抑郁症患者可能会出现大脑皮质的适应性代偿改变。     

受多重侵害后伴及不伴创伤后应激症状青年女性情绪处理的功能性磁共振成像研究

目的:探讨遭受多重侵害(PV)伴或不伴创伤后应激症状(PTSS)的女生加工不同情绪刺激的脑功能特点.方法:运用青少年侵害问卷(JVQ)和创伤后应激障碍症状清单平民版量表(PCL-C)对济南市某专科学校1802名学生的PV和PTSS进行筛查,筛选出30名遭受过多重侵害(JVQ总分≥5分、模块计分≥3分)的青年女性,其中,PCL-C得分≥38分者为PV有PTSS组(n=15); PCL-C得分＜38分者为PV无PTSS组(n=15).另筛选15名JVQ总分=0分,PCL-C得分＜38分者作为正常对照组.三组年龄、智力(使用瑞文标准推理测验评价)匹配.所有对象均接受国际情绪图片系统中正性-中性-负性三组图片刺激的脑功能磁共振成像扫描,任务为组块设计.利用SPM8软件处理影像数据.结果:识别正性图片时,PV无PTSS组双侧额上回(BA9),右侧额下回(BA47),左侧扣带前回(BA24、32)等脑区激活的强度高于对照组;识别负性图片时,右侧额中回(BA46),左侧扣带回(BA24)、岛叶激活的强度高于对照组.与PV有PTSS组相比,PV无PTSS组识别正性图片时,右侧额上回(BA6)、额中回(BA10),左侧额上回(BA10)、额下回(BA9)、岛叶激活增强,而右侧楔前叶激活降低;识别负性图片时,枕中回(BA19)激活增强,而右侧扣带前回(BA10),左侧额内侧回(BA9)、扣带前回(BA32)激活降低.结论:遭受多重侵害后无PTSS的青年女性情绪加工异常,主要表现在前额叶、扣带前回和岛叶活动性增强;有PTSS者加工负性情绪时,前额叶和扣带前回的功能异常加重.     

反社会行为人群大脑灰质结构改变的Meta分析

目的:通过Meta分析梳理反社会行为(Antisocial behavior,AB)人群大脑灰质结构改变的特点。方法:检索Pubmed、ScienceDirect、Web of Science和中国知网等数据库收录的有关AB人群大脑灰质结构的VBM研究文献,同时追踪相应参考文献,采用AE-SDM软件对纳入的研究进行基于体素的Meta分析。结果:共计纳入24个研究进入Meta分析。AB人群双侧额下回、缘上回和豆状核;左侧岛叶、杏仁核、额中回、颞上回和直回以及右侧中央后回等边缘-旁边缘系统脑区的灰质体积显著低于正常对照人群。Meta回归分析发现,AB人群上述脑区变化与其行为学特征具有显著相关。结论:反社会行为人群大脑灰质结构主要表现为额下回-岛叶-杏仁核-纹状体-缘上回等与情绪和共情加工能力有关脑区的改变。     

精神分裂症患者额叶、颞叶和边缘脑区的灰质体积下降

目的:探讨精神分裂症患者全脑灰质体积变化及其特点.方法:对85例精神分裂症患者和85例健康对照进行脑结构磁共振成像,以最近更新的基于体素的形态测量法检测两组的脑灰质体积差异.结果:精神分裂症患者存在脑灰质体积下降,主要位于双侧颞上回、岛叶和额下回,左侧海马和右侧颢下回.结论:额叶、颞叶和边缘脑区的异常可能是精神分裂症的关键的病理基础.     

Gray matter reduction associated with psychopathology and cognitive dysfunction in unipolar depression: a voxel-based morphometry study

BACKGROUND: Functional neuroimaging studies on both cognitive processing and psychopathology in patients with major depression have reported several functionally aberrant brain areas within limbic-cortical circuits. However, less is known about the relationship between psychopathology, cognitive deficits and regional volume alterations in this patient population. METHODS: By means of voxel-based morphometry (VBM) and a standardized neuropsychological test battery, we examined 15 patients meeting DSM-IV criteria for major depression disorder and 14 healthy controls in order to investigate the relationship between affective symptoms, cognitive deficits and structural abnormalities. RESULTS: Patients with depression showed reduced gray matter concentration (GMC) in the left inferior temporal cortex (BA 20), the right orbitofrontal (BA 11) and the dorsolateral prefrontal cortex (BA 46). Reduced gray matter volume (GMV) was found in the left hippocampal gyrus, the cingulate gyrus (BA 24/32) and the thalamus. Structure-cognition correlation analyses revealed that decreased GMC of the right medial and inferior frontal gyrus was associated with both depressive psychopathology and worse executive performance as measured by the Wisconsin Card Sorting Test (WCST). Furthermore, depressive psychopathology and worse performance during the WCST were associated with decreased GMV of the hippocampus. Decreased GMV of the cingulate cortex was associated with worse executive performance. LIMITATIONS: Moderate illness severity, medication effects, and the relatively small patient sample size should be taken into consideration when reviewing the implications of these results. CONCLUSIONS: The volumetric results indicate that regional abnormalities in gray matter volume and concentration may be associated with both psychopathological changes and cognitive deficits in depression.     

Distinct Patterns of Brain Atrophy associated with Mild Behavioral Impairment in Cognitively Normal Elderly Adults

A cross-sectional study was conducted to evaluate patterns of gray matter changes in cognitively normal elderly adults with mild behavioral impairment (MBI). Sixteen MBI patients and 18 healthy controls were selected. All the participants underwent a neuropsychological assessment battery, including the Mini-mental State Examination (MMSE), Geriatric Depression Scale (GDS), Self-rating Anxiety Scale (SAS), and Chinese version of the mild behavioral impairment-checklist scale (MBI-C), and magnetic resonance imaging (MRI) scans. Imaging data was analyzed based on voxel-based morphometry (VBM). There was no significant difference in age, gender, MMSE score, total intracranial volume, white matter hyperdensity, gray matter volume, white matter volume between the two groups (p > 0.05). MBI group had shorter education years and higher MBI-C score, GDS and SAS scores than the normal control group (p < 0.05). For neuroimaging analysis, compared to the normal control group, the MBI group showed decreased volume in the left brainstem, right temporal transverse gyrus, left superior temporal gyrus, left inferior temporal gyrus, left middle temporal gyrus, right occipital pole, right thalamus, left precentral gyrus and left middle frontal gyrus(uncorrected p < 0.001). The grey matter regions correlated with the MBI-C score included the left postcentral gyrus, right exterior cerebellum, and left superior frontal gyrus. This suggests a link between MBI and decreased grey matter volume in cognitively normal elderly adults. Atrophy in the left frontal cortex and right thalamus in MBI patients is in line with frontal-subcortical circuit deficits, which have been linked to neuropsychiatric symptoms (NPS) in dementia. These initial results imply that MBI might be an early harbinger for subsequent cognitive decline and dementia.     

White matter hyperintensities-related cortical changes and correlation with mild behavioral impairment

PurposeThe aim of this study was to analyze cortical thickness and gray matter volume (GMV) changes in white matter hyperintensities (WMH) which were associated brain regions and their association with mild behavioral impairment (MBI) by means of voxel- and surface-based morphology (VBM and SBM).MethodsA total of 60 patients underwent 3T MRI scan and MBI checklist (MBI-C) assessment and were divided into two groups: lower WMH (LWMH) and higher WMH (HWMH). After adjusting for confounding factors i.e. age, gender, education, and total intracranial volume, we found a GMV decrease in the left anterior insula (AIns), right middle frontal gyrus, right central operculum, right fusiform gyrus, left cerebellum exterior, and thalamus proper in the HWMH group based VBM, while in the HWMH group based SBM we found cortical thickness decrease in the left lingual, right posterior cingulate cortex (rPCC), right precentral, left superior frontal, right medial orbitofrontal gyrus, and left pars opercularis.ResultsThe HWMH group had higher MBI-C scores. The GMV in the left AIns and thalamus proper and the thickness of rPCC negatively correlated with the MBI-C scores. The mediation analysis suggested that WMH may partially mediate MBI-C scores by reducing the GMV and cortical thickness of the mentioned brain regions.ConclusionsIn WMH patients, the occurrence of MBI is associated with atrophy of gray matter and cortex. The occurrence of MBI may be partially mediated by WMH through gray matter and cortical atrophy. It provides a new insight into the relationship between WMH and dementia.     

Structural and functional abnormalities in migraine patients without aura

Migraine is a primary headache disorder characterized by recurrent attacks of throbbing pain associated with neurological, gastrointestinal and autonomic symptoms. Previous studies have detected structural deficits and functional impairments in migraine patients. However, researchers have failed to investigate the functional connectivity alterations of regions with structural deficits during the resting state. Twenty‐one migraine patients without aura and 21 age‐ and gender‐matched healthy controls participated in our study. Voxel‐based morphometric (VBM) analysis and functional connectivity were employed to investigate the abnormal structural and resting‐state properties, respectively, in migraine patients without aura. Relative to healthy comparison subjects, migraine patients showed significantly decreased gray matter volume in five brain regions: the left medial prefrontal cortex (MPFC), dorsal anterior cingulate cortex (dACC), right occipital lobe, cerebellum and brainstem. The gray matter volume of the dACC was correlated with the duration of disease in migraine patients, and thus we chose this region as the seeding area for resting‐state analysis. We found that migraine patients showed increased functional connectivity between several regions and the left dACC, i.e. the bilateral middle temporal lobe, orbitofrontal cortex (OFC) and left dorsolateral prefrontal cortex (DLPFC). Furthermore, the functional connectivity between the dACC and two regions (i.e. DLPFC and OFC) was correlated with the duration of disease in migraine patients. We suggest that frequent nociceptive input has modified the structural and functional patterns of the frontal cortex, and these changes may explain the functional impairments in migraine patients. Copyright © 2012 John Wiley & Sons, Ltd.     

强迫症患者大脑灰质体积变化——基于体素的形态学分析

目的探讨强迫症(OCD)患者大脑灰质体积的变化,并分析其在发病过程中可能存在的相关机制。方法选择31例年龄17～47岁重度强迫症患者和31例正常对照被试者,获取脑结构磁共振T1图像,使用基于体素的形态学测量(VBM)方法,比较强迫症组和对照组大脑灰质体积的差异,并将患者灰质体积差异区与其临床评分进行相关分析。结果与对照组相比,OCD患者在左侧壳核、岛叶、运动前区、顶上小叶以及右侧角回处体积显著减小。左侧壳核和岛叶的体积与患者贝克焦虑量表(BAI)评分成显著负相关。结论左侧壳核、岛叶、运动前区、顶上小叶以及右侧角回的灰质体积变化影响了该脑区功能,从而导致了OCD患者的部分症状。其中左侧壳核以及岛叶的损伤与患者焦虑情绪的异常密切相关。     

Neuroanatomical correlates of trait anhedonia in patients with schizophrenia: A voxel-based morphometric study

The aim of this study was to characterize the association between trait anhedonia and regional gray matter volume in patients with schizophrenia. Forty-six patients with schizophrenia and 56 healthy controls underwent magnetic resonance imaging (MRI) to acquire high-resolution T1-weighted images. Trait anhedonia was measured using the Chapman Revised Physical Anhedonia Scale (PAS). Voxel-based morphometry was performed to investigate brain volume correlates of trait anhedonia. Several brain regions in the patient group, including the left precuneus and right posterior cingulate (PCC), were found to show significantly less correlation with PAS scores than those of the control group. Post-hoc analysis revealed that negative correlations between the regional gray matter volume and the PAS scores in the patient group were found at a trend level in the left precuneus and the right PCC. In conclusion, these findings suggest that trait anhedonia in patients with schizophrenia could possibly be associated with a volume deficit in brain regions related to default-mode, which reflects the impairment of self-referential processing and reward anticipation.     

Abnormalities of the left temporal lobe and thought disorder in schizophrenia. A quantitative magnetic resonance imaging study.

BACKGROUND. Data from postmortem, CT, and magnetic resonance imaging (MRI) studies indicate that patients with schizophrenia may have anatomical abnormalities of the left temporal lobe, but it is unclear whether these abnormalities are related to the thought disorder characteristic of schizophrenia. METHODS. We used new MRI neuroimaging techniques to derive (without knowledge of the diagnosis) volume measurements and three-dimensional reconstructions of temporal-lobe structures in vivo in 15 right-handed men with chronic schizophrenia and 15 matched controls. RESULTS. As compared with the controls, the patients had significant reductions in the volume of gray matter in the left anterior hippocampus-amygdala (by 19 percent [95 percent confidence interval, 3 to 36 percent]), the left parahippocampal gyrus (by 13 percent [95 percent confidence interval, 3 to 23 percent], vs. 8 percent on the right), and the left superior temporal gyrus (by 15 percent [95 percent confidence interval, 5 to 25 percent]). The volume of the left posterior superior temporal gyrus correlated with the score on the thought-disorder index in the 13 patients evaluated (r = -0.81, P = 0.001). None of these regional volume decreases was accompanied by a decrease in the volume of the overall brain or temporal lobe. The volume of gray matter in a control region (the superior frontal gyrus) was essentially the same in the patients and controls. CONCLUSIONS. Schizophrenia involves localized reductions in the gray matter of the left temporal lobe. The degree of thought disorder is related to the size of the reduction in volume of the left posterior superior temporal gyrus.     

Anatomical measurements of the orbitofrontal cortex in child and adolescent patients with bipolar disorder

Imaging studies indicate smaller orbitofrontal cortex (OFC) volume in mood disorder patients compared with healthy subjects. We sought to determine whether child and adolescent patients with bipolar disorder have smaller OFC volumes than healthy controls. Fourteen children and adolescents meeting DSM-IV criteria for bipolar disorder (six males and eight females with a mean age+/-S.D.=15.5+/-3.2 years) and 20 healthy controls (11 males and nine females with mean age+/-S.D.=16.9+/-3.8 years) were studied. Orbitofrontal cortex volume was measured using magnetic resonance imaging. Male bipolar patients had smaller gray matter volumes in medial (p=0.044), right medial (0.037) and right (p=0.032) lateral OFC subdivisions compared to male controls. In contrast, female patients had larger gray matter volumes in left (p=0.03), lateral (p=0.012), left lateral (p=0.007), and trends for larger volumes in right lateral and left medial OFC subdivisions compared with female controls. Male patients exhibit smaller gray matter volumes, while female patients exhibit larger volumes in some OFC sub-regions. Gender differences in OFC abnormalities may be involved in illness pathophysiology among young bipolar patients.     

Effect of temporal lobe structure volume on memory in elderly depressed patients

Objective

To compare the volume of the hippocampus and parahippocampal gyrus in elderly individuals with and without depressive disorders, and to determine whether the volumes of these regions correlate with scores on memory tests.

Method

Clinical and demographic differences, as well as differences in regional gray matter volumes, were assessed in 48 elderly patients with depressive disorders and 31 control subjects. Brain (structural MRI) scans were processed using statistical parametric mapping and voxel-based morphometry. Cognitive tests were administered to subjects in both groups.

Results

There were no between-group gray matter volume differences in the hippocampus or parahippocampal gyrus. In the elderly depressed group only, the volume of the left parahippocampal gyrus correlated with scores on the delayed naming portion of the visual-verbal learning test. There were also significant direct correlations in depressed subjects between the volumes of the left hippocampus, right and left parahippocampal gyrus and immediate recall scores on verbal episodic memory tests and visual learning tests. In the control group, there were direct correlations only between overall cognitive performance (as assessed with the MMSE) and the volume of right hippocampus, and between the total score on the visual-verbal learning test and the volume of the right and left parahippocampal gyrus.

Conclusions

These findings highlight different patterns of relationship between cognitive performance and volumes of medial temporal structures in depressed individuals and healthy elderly subjects. The direct correlation between delayed visual-verbal memory recall scores with left parahippocampal volumes specifically in elderly depressed individuals provides support to the view that depression in elderly populations may be a risk factor for dementia.     

基于体素的形态学分析唇腭裂患儿脑结构特征

目的 采用基于体素的形态学分析(VBM)方法探讨唇腭裂患儿脑结构特征.方法 在1.5 T磁共振扫描仪上采集数据,运用优化VBM方法比较10例唇腭裂患儿及10例正常对照婴幼儿的脑结构.对2组婴幼儿的灰白质密度和体积进行基于体素的双样本t检验,对比结果采用国际通用的统计参数图(SPM)表示,分析唇腭裂患儿大脑灰质密度及体积异常区域分布特征及其临床意义.结果 唇腭裂组的灰质体积在属于额上回的双侧前额叶内侧显著低于正常对照组(差异团簇体积体素个数:5220、4871,团簇水平校正后P值均小于0.05),灰质密度在左侧颞上回显著高于正常对照组(体素水平校正后P值小于0.05),脑白质密度和体积均无显著性的差异.结论 唇腭裂患儿与听觉及认知有关的皮层可能异于正常婴幼儿,应对此类患儿进行中枢听觉处理功能及认知功能的早期检查和早期干预.