基于体素的形态学方法对抑郁症患者的脑结构磁共振研究

目的 运用基于体素的形态学分析方法探究首发未治疗抑郁症患者的脑灰质体积变化,探讨抑郁症患者有关脑区脑结构改变,为深入理解抑郁症的发病机制提供新的思路.方法 前瞻性连续纳入抑郁症患者30例,正常对照24例,使用同一台PHILPS 3.0T磁共振机器对所有受试者进行MRI结构像扫描,并采用基于体素的形态学分析方法对其脑灰质...     

基于体素的形态学测量的重症肌无力患者脑结构改变研究及其与认知功能障碍的相关性分析

目的分析重症肌无力(MG)患者是否存在认知功能障碍及脑结构改变, 从脑结构角度探讨MG认知功能损害的可能机制。方法选择苏州大学附属第一医院神经内科自2019年7月至2021年12月收治的28例MG患者作为MG组, 选择MG患者家属或同期于医院体检中心体检的健康体检者共30例作为健康对照组。采用神经心理学测试评估受试者的认知功能;采用基于体素的形态学测量(VBM)方法分析受试者结构磁共振成像(sMRI)上脑结构的改变, 采用相关性分析检验MG组患者差异脑区的灰质体积与认知功能的相关性。结果与健康对照组比较, MG组患者的简易智力状态检查量表(MMSE)评分、蒙特利尔认知评估量表(MoCA)评分、画钟测验(CDT)评分、词语流畅性测验(VFT)评分、Rey听觉词语学习测验(RAVLT)即刻记忆评分和延迟记忆评分均降低, 而连线测验A部分(TMT-A)耗时、汉密尔顿抑郁量表(HAMD)评分和汉密尔顿焦虑量表(HAMA)评分均增高, 差异均有统计学意义(P<0.05);与健康对照组比较, MG组患者左侧眶部额上回、右侧眶部额中回、右侧三角部额下回、左侧脑岛、左侧额中回、右侧缘上回、右侧前...     

失独伴慢性创伤后应激障碍患者脑基于体素形态学及功能连接分析

目的:探讨失独伴慢性创伤后应激障碍（posttraumatic stress disorder, PTSD）患者脑灰质体积和功能连接改变及其与PTSD症状的关系。方法:2017年10月至2019年5月共纳入19例伴慢性PTSD失独者（伴PTSD组）、28例不伴PTSD失独者（不伴PTSD组）及27例健康对照者（对照组）...     

首发未服药精神分裂症患者脑弥散张量成像的基于体素分析

目的分析首发未服药精神分裂症患者脑白质完整性的变化。 方法对40例首发未服药精神分裂症患者和68例健康对照者进行脑弥散张量磁共振成像检查,以DTI-studio软件和统计参数图(SPM)软件对所得图像进行预处理,得到的各向异性分数(FA)图像在SPM软件中进行两样本t检验,获得两组患者FA值差异统计参数图。 结果在P值小于0.001（未校正）水平下,首发未服药精神分裂症患者右侧杏仁核区(MNI：24,2,-14,cluster=347 voxels)、双侧前扣带区(MNI:6,42,2,cluster=586 voxels)、右侧前额叶眶上回区域(MNI：20,18,-10,cluster= 166 voxels)白质FA值较健康对照者下降,且未发现前者有脑区白质FA值较后者增高。 结论精神分裂症患者皮层一边缘系统环路存在结构连接障碍,这可能是精神分裂症的神经机制。     

原发性舌咽神经痛患者全脑灰质体积变化：基于体素的形态学分析

目的从脑形态学角度探讨舌咽神经痛(GPN)的潜在中枢发病机制。方法前瞻性选择北京大学人民医院神经外科自2019年4月至2023年6月收治的27例右侧原发性GPN患者(病例组)及同期招募的27例年龄、性别、惯用手、受教育年限与病例组相匹配的健康人群(对照组)为研究对象, 并依据术中观察是否存在神经血管压迫将GPN患者分为伴神经血管压迫组(n=18)与不伴神经血管压迫组(n=9)。采用基于Matlab R2017b编程平台的SPM8软件和VBM8工具包处理受试者的全脑高分辨率3D-T1脑结构像数据, 分析不同组受试者间各脑区灰质体积的差异。应用Pearson相关性分析评估病例组患者的显著差异脑区灰质体积与其一般资料及疼痛特征的相关性。结果与对照组相比, 病例组患者左侧前扣带回、颞中回、颞横回、中央前回、中央后回及右侧岛叶、丘脑、顶下小叶、中央前回、颞中回、颞下回的灰质体积明显减小, 差异均有统计学意义(P<0.05, FDR校正)。与伴神经血管压迫组相比, 不伴神经血管压迫组患者双侧前扣带回的灰质体积明显减小, 差异有统计学意义(P<0.05, FDR校正)。病例组患者的右侧岛...     

基于体素的形态测量法分析高功能孤独性障碍患儿的脑组织密度

目的 分析学龄孤独性障碍患儿脑组织密度.方法 对17例智能正常的孤独性障碍患儿(病例组)以及15名年龄、性别、智商与之相匹配的健康儿童(对照组)进行T1加权三维磁共振成像扫描,应用基于体素的形态测量法(VBM)比较两组脑灰质及脑白质密度的差异.结果 与对照组相比,孤独性障碍患儿右侧小脑前叶的脑灰质密度低.右前扣带回、右额中回区域的脑白质密度低,双侧顶下小叶、右缘上回、右中央后回、右颞上回、右小脑后叶、左楔前叶、左楔叶的脑灰质密度高(P<0.001).结论 智力正常的学龄孤独性障碍患儿脑组织密度异常明显,且部位广泛.     

基于体素的形态学测量的创伤后应激障碍患者脑结构变化研究

目的探讨交通事故致创伤后应激障碍(PTSD)患者的脑结构形态学改变。方法选择46例经历交通事故后自2021年1月至2022年6月就诊于广东省第二人民医院心理精神科的PTSD患者(PTSD组)以及同期招募的49例性别、年龄相匹配的正常健康者(对照组)为研究对象。所有受试者均行全脑MRI 3D-T1WI结构像扫描, 并应用基于体素的形态学测量(VBM)方法分析2组受试者间脑区灰质体积的差异, 并对PTSD组较对照组有差异的脑区灰质体积与其临床用创伤后应激障碍诊断量表(CAPS)、创伤后应激障碍自评量表(PCL-C)及汉密尔顿抑郁量表(HAMD)评分进行相关性分析。结果与对照组相比, PTSD组左侧海马、左侧中央后回及右侧额上回灰质体积明显缩小, 差异均有统计学意义(P<0.001, GRF校正), 未发现较对照组灰质体积增加的脑区。PTSD组患者的左侧中央后回灰质体积与其CAPS评分呈负相关关系(r=-0.443, P=0.002), 其余有差异的脑区灰质体积与CAPS、PCL-C及HAMD评分间均无相关性(P>0.05)。结论交通事故致PTSD患者存在左侧海马、左侧中央后回及...     

Structural changes in the gray matter of unmedicated patients with obsessive-compulsive disorder: a voxel-based morphometric study

The aim of the current study was to use whole brain voxel-based morphometry（VBM）to assess the gray matter（GM）changes in unmedicated patients with obsessive-compulsive disorder（OCD）compared with normal controls.We compared the GM volumes in28 patients with 22 matched healthy controls using a1.5T MRI.Three-dimensional T1-weighted magnetic resonance images were obtained from all participants.VBM was performed to detect GM volume differences between the two groups.We detected increased regional GM volumes in the bilateral middle temporal gyri,bilateral middle occipital gyri,bilateral globus pallidus,right inferior parietal gyrus,left superior parietal gyrus,right parahippocampus,right supramarginal gyrus,right medial superior frontal gyrus,and left inferior frontal opercular cortex in the OCD patients relative to controls（P〈0.001,uncorrected,cluster size〉100 voxels）.No decreased GM volume was found in the OCD group compared with normal controls.Our findings suggest that structural changes in the GM are not limited to fronto-striato-thalamic circuits in the pathogenesis of OCD.Temporo-parietal cortex may also play an important role.     

Frontal lobe gray matter density decreases in bipolar I disorder.

BACKGROUND: This study was conducted to explore differences in gray and white matter density between bipolar and healthy comparison groups using voxel-based morphometry (VBM). METHODS: Brain magnetic resonance imaging was performed for 39 subjects with bipolar I disorder and 43 comparison subjects. Images were registered into a proportional stereotaxic space and segmented into gray matter, white mater, and cerebrospinal fluid. Statistical parametric mapping was used to calculate differences in gray and white matter density between groups. RESULTS: Bipolar subjects had decreased gray matter density in left anterior cingulate gyrus (Brodmann's area [BA] 32, 7.3% decrease), an adjacent left medial frontal gyrus (BA 10, 6.9% decrease), right inferior frontal gyrus (BA 47, 9.2% decrease), and right precentral gyrus (BA 44, 6.2% decrease), relative to comparison subjects. CONCLUSIONS: The observation of a gray matter density decrease in the left anterior cingulate, which processes emotions, in bipolar subjects is consistent with prior reports that used region-of-interest analytic methods. Decreased gray matter density in the right inferior frontal gyrus, which processes nonverbal and intrinsic functions, supports nondominant hemisphere dysfunction as a component of bipolar disorder.     

Brain structure in post-traumatic stress disorder A voxel-based morphometry analysis

This study compared the difference in brain structure in 12 mine disaster survivors with chronic post-traumatic stress disorder,7 cases of improved post-traumatic stress disorder symptoms,and 14 controls who experienced the same mine disaster but did not suffer post-traumatic stress disorder,using the voxel-based morphometry method.The correlation between differences in brain structure and post-traumatic stress disorder symptoms was also investigated.Results showed that the gray matter volume was the highest in the trauma control group,followed by the symptoms-improved group,and the lowest in the chronic post-traumatic stress disorder group.Compared with the symptoms-improved group,the gray matter volume in the lingual gyrus of the right occipital lobe was reduced in the chronic post-traumatic stress disorder group.Compared with the trauma control group,the gray matter volume in the right middle occipital gyrus and left middle frontal gyrus was reduced in the symptoms-improved group.Compared with the trauma control group,the gray matter volume in the left superior parietal lobule and right superior frontal gyrus was reduced in the chronic post-traumatic stress disorder group.The gray matter volume in the left superior parietal lobule was significantly positively correlated with the State-Trait Anxiety Inventory subscale score in the symptoms-improved group and chronic post-traumatic stress disorder group(r=0.477,P=0.039).Our findings indicate that(1) chronic post-traumatic stress disorder patients have gray matter structural damage in the prefrontal lobe,occipital lobe,and parietal lobe,(2) after post-traumatic stress,the disorder symptoms are improved and gray matter structural damage is reduced,but cannot recover to the trauma-control level,and(3) the superior parietal lobule is possibly associated with chronic post-traumatic stress disorder.Post-traumatic stress disorder patients exhibit gray matter abnormalities.     

Gray matter abnormalities in patients with narcissistic personality disorder

Background

Despite the relevance of narcissistic personality disorder (NPD) in clinical settings, there is currently no empirical data available regarding the neurobiological correlates of NPD. In the present study, we performed a voxel-based morphometric analysis to provide initial insight into local abnormalities of gray matter (GM) volume.

Methods

Structural brain images were obtained from patients with NPD (n = 17) and a sample of healthy controls (n = 17) matched regarding age, gender, handedness, and intelligence. Groups were compared with regard to global brain tissue volumes and local abnormalities of GM volume. Regions-of-interest analyses were calculated for the anterior insula.

Results

Relative to the control group, NPD patients had smaller GM volume in the left anterior insula. Independent of group, GM volume in the left anterior insula was positively related to self-reported emotional empathy. Complementary whole-brain analyses yielded smaller GM volume in fronto-paralimbic brain regions comprising the rostral and median cingulate cortex as well as dorsolateral and medial parts of the prefrontal cortex.

Conclusion

Here we provide the first empirical evidence for structural abnormalities in fronto-paralimbic brain regions of patients with NPD. The results are discussed in the context of NPD patients' restricted ability for emotional empathy.     

Conduct disorder and antisocial personality disorder in persons with severe psychiatric and substance use disorders

Conduct disorder (CD) and antisocial personality disorder (ASPD) are established risk factors for substance use disorders in both the general population and among persons with schizophrenia and other severe mental illnesses. Among clients with substance use disorders in the general population, CD and ASPD are associated with more severe problems and criminal justice involvement, but little research has examined their correlates in clients with dual disorders. To address this question, we compared the demographic, substance abuse, clinical, homelessness, sexual risk, and criminal justice characteristics of 178 dual disorder clients living in 2 urban areas between 4 groups: No CD/ASPD, CD Only, Adult ASPD Only, and Full ASPD. Clients in the Adult ASPD Only group tended to have the most severe drug abuse severity, the most extensive homelessness, and the most lifetime sexual partners, followed by the Full ASPD group, compared with the other 2 groups. However, clients with Full ASPD had the most criminal justice involvement, especially with respect to violent charges and convictions. The results suggest that a late-onset ASPD subtype may develop in clients with severe mental illness secondary to substance abuse, but that much criminal behavior in clients with dual disorders may be due to the early onset of the full ASPD syndrome in this population and not the effects of substance use disorders.     

White matter abnormalities in bipolar disorder and schizophrenia detected using diffusion tensor magnetic resonance imaging

Objectives:  Strong qualitative and quantitative evidence exists of white matter abnormalities in both schizophrenia and bipolar disorder (BD). Diffusion tensor imaging (DTI) studies suggest altered connectivity in both disorders. We aim to address the diagnostic specificity of white matter abnormalities in these disorders.
Methods:  DTI was used to assess white matter integrity in clinically stable patients with familial BD (n = 42) and familial schizophrenia (n = 28), and in controls (n = 38). Differences in fractional anisotropy (FA) were measured using voxel-based morphometry and automated region of interest analysis.
Results:  Reduced FA was found in the anterior limb of the internal capsule (ALIC), anterior thalamic radiation (ATR), and in the region of the uncinate fasciculus in patients with BD and those with schizophrenia compared with controls. A direct comparison between patient groups found no significant differences in these regions. None of the findings were associated with psychotropic medication.
Conclusions:  Reduced integrity of the ALIC, uncinate fasciculus, and ATR regions is common to both schizophrenia and BD. These results imply an overlap in white matter pathology, possibly relating to risk factors common to both disorders.     

Reduced anterior and posterior cingulate gray matter in borderline personality disorder.

BACKGROUND: Structural abnormalities in prefrontal and cingulate gyrus regions-important in affective processing, impulse control and cognition may contribute to the psychopathology of borderline personality disorder (BPD). Previous MRI studies examining volume have reported that compared with healthy controls, BPD patients have decreases in right anterior cingulate, no differences in dorsolateral prefrontal cortex, and mixed findings for prefrontal cortex. We extended this investigation by examining gray and white matter volume of frontal and cingulate gyrus Brodmann areas (BAs) in a large group of patients and healthy controls. METHODS: MRI scans were acquired in 50 BPD patients (n = 13 with comorbid diagnosis of BPD and Schizotypal Personality Disorder (SPD) and n = 37 without SPD) and 50 healthy controls, and gray/white matter volume in cingulate gyrus and frontal lobe BAs were assessed. Normal BPD and BPD subgroup comparisons were conducted. RESULTS: Compared with controls, BPD patients showed reduced gray matter volume in BA 24 and 31 of the cingulate. BPD patients without comorbid SPD had isolated gray matter volume loss in BA 24, but were spared for BA 31 in contrast to BPD patients with SPD. There were no group differences in whole cingulate or frontal lobe volume. CONCLUSIONS: The finding of more pervasive cingulate shrinkage in the patients with BPD and SPD comorbidity resembles recent observations with the same methods in patients with schizophrenia. The pattern of reduced anterior and posterior cingulate gray matter volume in BPD patients, particularly those comorbid for SPD is consistent with the affective and attentional deficits observed in these personality disorders.     

反社会人格障碍患者的脑灰质结构研究

目的 研究反社会人格障碍(APD)患者与正常人大脑灰质结构的异同.方法 对17例APD患者(APD组)和19名与APD组的年龄、性别、智商及文化程度匹配的正常对照者(正常对照组)进行脑部T1加权像及3维结构像扫描,并使用基于体素的形态学分析法进行数据分析.结果 APD组左额上回(BA8)、右楔前叶、左眶额回、双侧额中同、右额内侧同、右侧顶下小叶、左梭状回、双侧颞上回及双侧小脑的灰质密度低于正常对照组,而左额上回(BA38)及左海马旁回的密度高于正常对照组(P<0.005).结论 APD患者存在脑结构的异常,主要包括前额叶、眶额回、楔前叶、颞叶及双侧小脑.