女性抑郁状态患者海马形态体积的变化

目的 探讨女性抑郁患者的双侧海马及其各部形态体积变化的特点.方法 采用3.0 T磁共振,分别测量女性抑郁患者(30例,抑郁组)及对照组(30名)的海马及其各部体积和层数.结果 (1)抑郁组左侧海马头平均层面积(121±33)mm2,小于对照组的(148±32)mm2;层数(14.9±3.2)层,多于对照组的(12.3±3.1)层;P均<0.01;抑郁组左右侧尾部层数[(5.9±2.6)层,(6.4±1.8)层]少于对照组[(7.7±2.5)层,(7.8±2.3)层],P<0.05.(2)抑郁组左右侧海马体积[(3164±218)mm3,(3202±202)mm3]、于对照组[(3324±334)mm3,(3338±301)mm3],P<0.05,海马左右侧尾体积[(384±120)mm3,(414±101)mm3]亦小于对照组[(498±134)mm3,(501±121)mm3],P<0.01.结论 左侧海马头部形态改变和两侧海马尾体积缩小及其形态改变可能是女性抑郁患者的特征之一.     

抑郁症首次发病患者海马磁共振质子波谱成像的研究

目的 探讨抑郁症首次发病患者海马的磁共振质子波谱(1H-MRS)代谢物质的变化.方法 对99例首次发病的抑郁症患者和26例健康对照组行磁共振常规扫描及1H-MRS检查,测量双侧海马N-乙酰天门冬氨酸(NAA)、胆碱复合物(Cho)和肌酸(Cr)三种代谢物质,计算NAA/Cr和Cho/Cr比值.结果 抑郁症患者海马NAA/Cr左右侧比值(1.23±0.16;1.16±0.16)低于对照组NAA/Cr左右侧比值(1.38±0.23;1.31±0.26),差异有显著性(P<0.05);抑郁症患者海马体部Cho/Cr左右侧比值(1.19±0.14;1.18±0.12)高于对照组Cho/Cr左右侧比值(1.14±0.12;1.11±0.14),差异有显著性(P<0.05).对照组左右侧NAA/Cr和Cho/Cr比较差异无显著性(P>0.05).抑郁症组右侧NAA/Cr低于左侧,差异显著(P<0.05);左侧Cho/Cr高于右侧,差异不明显(P>0.05).结论 抑郁症患者可能存在双侧海马神经细胞代谢功能障碍,右侧神经细胞功能障碍较左侧明显.     

中国人脑立体定位MRI海马结构体积的测定

目的 测量标准立体定位空间获得的健康中国人脑MRI海马结构的体积,为应用体积测量方法早期诊断颞叶癫痫等疾病提供影像学的参考标准.方法 在标准立体定位空间对100例健康中国人脑进行T1加权像MRI扫描,在冠状位MRI上应用软件测量海马结构的体积,并进行相关统计学分析.结果 在标准立体定位空间MRI能够较清晰、真实的显示海马结构.男女海马结构体积分别为2981.39±297.47 mm3和2970.43±330.13 mm3,性别之间海马结构的体积差异无显著性意义(P＞0.05);左右侧体积分别为2949.67±327.06mm3和3001.81±298.97mm3 ,左右侧海马的体积存在显著性差异(P＜0.05),右侧大于左侧.在20～29岁、30～39岁、40～49岁、50～59岁组间MRI海马结构的体积差异无显著性意义(P＞0.05),而20～29岁、30～39岁、40～49岁、50～59岁组与60～69岁组间经统计学分析发现具有显著性差异(P＜0.05),60岁以后,海马体积逐渐缩小.结论 在标准立体定位空间获得的海马结构体积与性别无关,右侧海马结构体积大于左侧(P＜0.05).60岁以后,海马结构体积随年龄增加而逐渐缩小,因此在MRI影像学诊断海马结构病变时应给予重视.     

抑郁症与精神分裂症患者的脑电生理反应时间比较研究

目的 了解抑郁症及精神分裂症患者反应时间的特点.方法 应用国产脑电生理仪以及短音和视觉刺激,测查31例抑郁症、33例精神分裂症和30名正常对照组的反应时间.结果 精神分裂症组和抑郁症组及正常对照组在听反应时间和视反应时间两两比较上均有显著性差异:正常对照组听反应时间 (231±30)ms,精神分裂症患者(279±34)ms,抑郁症患者(264±33)ms,(F=17.81,P<0.01);正常对照组视反应时间 (246±30)ms,精神分裂症患者(394±47)ms,抑郁症患者(289±41)ms,(F=49.04,P<0.01)).上述三组第二轮听、视反应时间与警告信号后负电位(PINV)变化表现为同一趋势,即听、视反应时间延迟,PINV随之延长.结论 反应时间可辅助抑郁症和精神分裂症患者的认知功能评定.     

抽动秽语综合征患者基底节结构特点分析

目的探讨抽动秽语综合征(Tourette syndrome,TS)患者可能存在的基底节结构改变.方法对10例右利手男性TS患者和10例匹配正常健康人进行头颅MRI检查,应用三维重建技术分别对尾状核、壳核、苍白球和全脑体积进行测量,比较两组之间的基底节体积差异,分析左右侧结构体积的对称性.结果对照组左侧基底节体积大于右侧(P＜0.05);TS组双侧基底节各结构体积均明显减小,左侧更显著,左右侧体积比较无显著差异(P＞0.05);基底节各结构体积与症状严重程度不相关.结论正常右利手人群中存在着基底节结构体积不对称性,左侧偏大;双侧基底节体积减小、丧失正常的不对称性,是TS患者的特征性结构改变.     

首发抑郁症海马体积及影响因素研究

目的 探讨首发抑郁症患者海马体积的特点.方法 应用磁共振成像(MRI)检测17例未用药首发抑郁症患者和19名正常对照的海马体积.结果 患者组双侧海马绝对体积(AHV)以及AHV/颅内脑体积(ICV)与对照组之间的差异均无统计学意义(P>0.05),左侧海马的AHV/ICV(1.380±0.162)低于右侧(1.462±0.105)和对照组左侧(1.478±0.133),但差异无统计学意义(P分别为0.055和0.051).未见年龄、病程和汉密尔顿抑郁量表评分与海马体积相关(P>0.05).结论 未发现首发抑郁症患者海马体积异常.     

抑郁症首次发病与复发患者的空间认知功能的研究

目的:探讨首次发病与复发的抑郁症患者空间认知功能的差异. 方法:对30例首次发病的抑郁症患者(首发组)、32例复发的抑郁症患者(复发组)进行视觉空间旋转任务检测,并与30名健康志愿者(对照组)比较. 结果:错误率:首发组[(16.9±5.1)％]、复发组[(33.7±7.1)％]显著高于对照组[(10.4±3.8)％],复发组显著高于首发组(P均＜0.05).反应时:首发组[(813.5 ±92.6)ms]、复发组[(972.6 ±94.5)ms]显著长于对照组[(737.1 ±86.5)ms],复发组显著长于首发组(P均＜0.05).线性回归分析:对照组及首发组正像及镜像错误率、反应时均随着旋转角度递增呈线性递增函数(P均＜0.01);复发组没有随着旋转角度递增呈线性递增函数. 结论:首发抑郁症患者因动机减弱、注意力下降致感知觉系统的识别与编码过程受损;复发抑郁症患者视觉空间认知功能受损.     

老年抑郁症恢复期患者认知损害与全脑白质纤维完整性的相关性研究

目的 探讨恢复期老年抑郁症患者全脑白质纤维完整性是否受损,并进一步分析其与认知损害是否关联.方法 对16例恢复期老年抑郁症患者(患者组)和14名健康老年人(对照组)进行汉密尔顿抑郁量表(HAMD)、简易智力状态检查(MMSE)和神经心理学评估后,行全脑弥散张量成像扫描,用SPM2软件处理图像,采用基于体素的分析方法进行组间比较分数各向异性(FA)值.结果 (1)HAMD、MMSE评分和神经心理学测试:患者组HAMD和MMSE评分与正常对照组的差异无统计学意义(P>0.05),但在听觉言语测验[(5.9±2.6)分]、连线测验A[(146±127)s]和B[(264±196)s]成绩均差于正常对照组[分别为(9.3±1.6)分,(73±25)s和(121±35)s;P<0.01～0.05].(2)FA值:患者组低于对照组的脑区主要包括:右侧额上回、左侧额下回、左侧颞中回、右侧顶下回、右侧枕中回、左侧舌回、右侧壳核和右侧尾状核(未校正,P<0.001).(3)患者组右侧额上回FA值与连线B测验成绩呈显著负相关(r=-0.556,P=0.049).结论 恢复期老年抑郁症患者多部位脑白质纤维的完整性受损,这可能是该类患者认知损害的神经病理基础.     

轻度认知损害患者空间导航能力相关皮质下核团体积研究

目的探讨轻度认知损害患者皮质下核团体积与空间导航能力之间的关系。方法采用计算机空间导航障碍测试系统测试30例轻度认知损害患者和性别、年龄、受教育程度相匹配的28例正常对照者空间导航能力,FreeSurfer 5.3.0软件对三维T1WI图像进行结构分割,计算皮质下核团(双侧丘脑、尾状核、壳核、苍白球、海马、杏仁体和伏隔核)体积以及全脑体积。Pearson相关分析分析空间导航能力与皮质下核团体积的相关性。结果轻度认知损害患者混合(环境参照和自我参照)导航(P=0.034)、自我参照导航(P=0.004)、环境参照导航(P=0.011)误差距离均大于正常对照者,而双侧丘脑(P=0.953,0.250)、尾状核(P=0.938,0.672)、壳核(P=0.421,0.912)、苍白球(P=0.446,0.360)、海马(P=0.545,0.647)、杏仁体(P=0.565,0.993)、伏隔核(P=0.271,0.796)和全脑(P=0.567)体积组间差异无统计学意义。Pearson相关分析显示,轻度认知损害患者混合(环境参照和自我参照)导航误差距离与左侧苍白球(r=-0.284,P=0.034)和左侧海马(r=-0.265,P=0.048)体积呈负相关,环境参照导航误差距离与左侧壳核体积呈负相关(r=-0.305,P=0.022)。结论轻度认知损害患者空间导航能力与皮质下核团体积相关,对进一步研究空间导航障碍的发生机制具有重要意义。     

2～3岁孤独谱系障碍儿童尾状核体积与重复刻板行为的关系

目的:对比2～3岁孤独谱系障碍(ASD)与发育迟缓(DD)儿童尾状核体积的差异,并探讨尾状核体积与重复刻板行为严重程度的关系。方法:使用ITK-SNAP软件分别计算并比较66例ASD儿童(ASD组)和36例年龄、性别、智商与之相匹配的DD儿童(DD组)的尾状核体积,并与由孤独症诊断访谈量表-修订版(ADI-R)所得重复刻板行为分数进行相关分析。结果:ASD组尾状核左侧(P=0.005)、右侧(P0.001)以及总体积(P=0.001)较DD组显著增大;尾状核左侧(r=0.359,P=0.004)、总体积(r=0.317,P=0.013)与ADI-R低水平重复刻板行为分呈显著正相关。结论:2～3岁的ASD儿童已表现出尾状核体积的异常增大,且与低水平的重复刻板行为有相关。     

Brain morphology and schizophrenia. A magnetic resonance imaging study of limbic, prefrontal cortex, and caudate structures.

We used magnetic resonance imaging to examine the morphologic characteristics of the amygdala/hippocampus, prefrontal cortex, and caudate nucleus in 29 healthy volunteers matched for age, gender, and head of household socioeconomic status and 44 patients with chronic schizophrenia. Total volumes of these structures were determined from 3-mm contiguous coronal sections. Schizophrenic patients, compared with healthy controls, had significantly smaller right and left amygdala/hippocampal complex volumes, smaller right and left prefrontal volumes, and larger left caudate volumes. A secondary analysis revealed reductions in the right and left amygdala and the left hippocampus. In addition, prefrontal white matter, but not gray matter, was reduced in the schizophrenic patients. Moreover, the right white matter volume in schizophrenic patients was significantly related to right amygdala/hippocampal volume (r = .39), data that provide preliminary support for a hypothesis of abnormal limbic-cortical connection in schizophrenia. We studied the implications of these data for the pathophysiology of schizophrenia.     

穹窿和乳头体立体定向MRI解剖学研究

目的探讨生理和病理状态下人脑穹窿和乳头体的MRI解剖学,为诊断相关疾病提供影像学基础。方法应用3．0MR机在标准立体定向空间内,对29例健康中国人和15例颞叶内侧癫痫患者行全脑扫描。测量穹窿和乳头体体积以及乳头体坐标。结果健康中国人穹窿体积左侧、右侧分别为（0．531±10．150）cm3和（0．541±0．143）cm3,乳头体左侧坐标为x=（一2．18±0．26）mm、Y=（3．76±0．49）mm、Z=（一7．48±0．73）mm,右侧坐标为X=（2．27±0．34）mm、Y=（3．73±0．67）mm、z=（一7．48±0．98）mm;乳头体长度为（4．53±0．54）mm、宽度为（4．25±0．41）mm、高度为（4．09±0．74）mm;健康中国人乳头体左侧、右侧体积分别为（54．77±7．99）mm3、（54．10±9．83）／mm3。同性别健康中国人的左右侧穹窿、乳头体体积无明显区别（P〉0．05）,乳头体的径线及坐标也无明显区别（P〉0．05）;不同性别间,同侧穹窿和乳头体体积、乳头体的径线及坐标均无明显区别（P〉0．05）。颞叶内侧癫痫患者的颞叶硬化侧穹窿、乳头体体积[分别为（0．403±0．110）cm3。和（27．80±8．06）mm3]较非硬化侧[分别为（0．526±0．174）cm3和（51．91±8．06）mm3]明显缩小（P〈0．05）。结论不同状态下,穹窿和乳头体MRI结构会发生相应变化,这些特点可为诊断相关疾病提供参考。     

A quantitative magnetic resonance imaging study of caudate and lenticular nucleus gray matter volume in primary unipolar major depression: relationship to treatment response and clinical severity

The authors investigated whether there were differences in caudate and lenticular nucleus volumes in depressed patients relative to comparison subjects, and whether differences in basal ganglia volume were associated with treatment response to fluoxetine. Brain magnetic resonance images were obtained from 38 unipolar depressed patients and 20 matched comparison subjects. Patients were divided into groups of 'responders' and 'non-responders' based on change in the 17-item Hamilton Depression Rating Scale (HDRS) score after a 10-week open trial of fluoxetine, 20 mg/day. There were no group mean differences in caudate and lenticular nucleus volumes between patients and comparison subjects. Female treatment responders tended to have larger caudate nucleus volumes than male 'responders', and also larger right caudate nucleus volumes than their female 'non-responder' counterparts. Baseline HDRS scores correlated negatively with left caudate nucleus volume in depressed patients. Thus, in mild to moderately depressed patients, we were unable to find differences in caudate and lenticular nucleus-gray matter volumes relative to comparison subjects. One possible reason is that caudate nucleus-gray matter volume and severity of depression are inversely correlated, suggesting that severity of depression may be an important covariate when comparing caudate volumes in depressed patients and control subjects.     

轻度认知障碍的海马、内嗅体积变化研究

目的研究轻度认知功能障碍(MCI)和阿尔兹海默病(AD)患者的海马、内嗅体积萎缩情况,评价利用高分辨影像学测定海马、内嗅体积对MCI、AD的诊断及预测价值。方法应用西门子3.0T磁共振分别对32例MCI患者,25例AD患者,32例正常的对照者进行3D T1WI扫描,并用freesurfer软件计算三组海马、内嗅体积,后用SPSS 17.0统计学软件进行资料的统计学处理,比较三组之间灰质体积的差异。评价在判断MIC中的价值。结果与对照组比较,MCI组[左侧(3.07±0.56)cm3,右侧(3.24±0.61)cm3]、AD组[左侧(2.81±0.64)cm3,右侧(3.01±0.67)cm3]的海马体积萎缩,其差异有统计学意义(P<0.01),且AD组比MCI组在海马体积(左侧0.26 cm3,右侧0.23cm3)均值上有更明显的萎缩;海马体积减小的程度与简易智能检查量表(MMSE)积分呈正相关性,而内嗅的体积变化在三组间的比较无统计学差异。结论通过Freesurfer测量的MRI形态学研究能够客观揭示AD早期阶段海马体积的萎缩改变,且海马体积萎缩与MMSE积分相结合对轻度认知障碍的诊断更准确。     

Volumetric MRI study of key brain regions implicated in obsessive-compulsive disorder

Neuroanatomic abnormalities have been implicated in the pathophysiology of obsessive-compulsive disorder (OCD). To date, no study has measured the orbito-frontal cortex (OFC), anterior cingulate, caudate nucleus, and thalamus concurrently in first-episode patients. Thus, we performed a volumetric MRI study in patients who were treatment-naive and healthy controls focusing on the in vivo neuroanatomy of the whole brain, total gray and white matter volume, thalamus, caudate nucleus, anterior cingulate cortex, and OFC concurrently. The volumes of thalamus, caudate nucleus, anterior cingulate cortex, and OFC were measured in 12 OCD patients who were treatment-naive and 12 healthy control subjects. Anterior cingulate and OFC volumes included both white and gray matters. Volumetric measurements were made with T1-weighted coronal MRI images, with 1.5-mm-thick slices, at 1.5 T. The patients had increased white matter volume than healthy controls. The patient group had significantly smaller left and right OFC volumes and significantly greater left and right thalamus volumes compared with healthy controls. Anterior cingulate exhibited a near-significant difference between the patients and healthy controls on left side. Significant correlations were found between Y-BOCS scores and left OFC, and right OFC, and between Y-BOCS and left thalamus volumes in the patient group. In conclusion, our findings suggest that abnormalities in these areas may play an important role in the pathophysiology of OCD.     

Caudate nucleus volume and its clinical and cognitive correlations in first episode schizophrenia

OBJECTIVE: Striatal dysfunction has been traditionally implicated in the pathophysiology of schizophrenia. The purpose of this study is to examine the relationship between caudate nucleus volumes and clinical and cognitive features of schizophrenic patients in an early phase of their illness. METHODS: Caudate nucleus volumes in previously untreated first episode patients with non-affective psychosis (N=76) and healthy comparison subjects (N=45) were measured. Caudate nucleus volume in the right and left hemispheres were automatically segmented and analyzed using BRAINS2. Analysis of covariance was used to control for intracranial volume. Severity of clinical symptoms was assessed using SAPS and SANS total scores. The relationship between cognitive dimensions, and caudate nucleus volume was evaluated. Finally, we examined the correlation between caudate volumes and the duration of untreated illness (DUI), duration of untreated psychosis (DUP) and duration of prodrome period (DPP). RESULTS: Right, left, and total caudate nucleus volumes did not differ significantly between patients and controls. Those patients with a longer DUP have smaller caudate nucleus. In addition, caudate nucleus volume was positively correlated with the severity of psychotic symptomatology. No significant associations were found between caudate nucleus volume and cognitive functioning. CONCLUSION: This group of first episode schizophrenia patients did not exhibit significant volumetric anomalies of the caudate nucleus. Despite this lack of volumetric abnormalities, a delay in receiving antipsychotic treatment and the severity of initial positive symptomatology were significantly associated with reduced caudate volume.     

MRI extrahippocampal volumes and visual memory: correlations independent of MRI hippocampal volumes in temporal lobe epilepsy patients.

Limbic system atrophy and memory dysfunction are common in patients with temporal lobe epilepsy (TLE). However, the relationship between extrahippocampal limbic structures and memory functioning within TLE has received little attention. The present study examined associations of MRI volumetric measurements of the mammillary body, fornix, amygdala, and hippocampus to measures of episodic verbal and visual memory. The Logical Memory and Visual Reproduction subtests from the Wechsler Memory Scale were administered to 47 unilateral TLE patients (25 right, 22 left). Normalized right and left MRI volumes were determined for each patient by cursor tracing 1.5 mm slices from 3D-MRI. Significant associations were found between left hippocampal volume and the immediate, delayed, and percent retention scores of the Logical Memory Test; between the left mammillary body volume and the Logical Memory Test delayed and percent retention scores; immediate Visual Reproduction performance was significantly related to the right and left amygdala volumes, and right mammillary body volume; only the right amygdala and right mammillary body volume were associated with the delayed Visual Reproduction trial. However, neither right nor left hippocampal volumes were related to visual memory performance. Multiple limbic system structural volumes were independently associated with verbal and nonverbal memory performance. Results suggest that visual memory, as measured by the Visual Reproduction Test, may be uniquely associated with extrahippocampal volumes in patients with TLE.     

Volumetric investigation of brain regions in patients with conversion disorder

Preliminary evidence revealed a decrease of regional cerebral blood flow in the thalamus and basal ganglia contralateral to the deficit and suggested that hysterical conversion deficits might entail a functional disorder in striatothalamocortical circuits. However, there is no systematic structural magnetic resonance imaging (MRI) study in the literature in patients with conversion disorder (CD). Therefore, we aimed to perform structural MRI to evaluate the brain regions of interest in first applying patients with CD. Morphometric MRI was used to compare regional brain volumes in ten women with CD and same number of healthy comparison subjects. Intracranial volume (ICV), whole brain volume, gray and white matter volumes did not differ between the patient and control groups. Patients with CD had significantly smaller mean volumes of the left caudate nucleus, lentiform nucleus (p<0.01 for caudate nucleus and p<0.05 for lentiform nucleus) and right caudate nucleus and lentiform nucleus (p<0.05 for both structures). In patients, the right thalamus was significantly smaller, and the left thalamus rendered to be smaller compared to healthy controls. Age at onset showed a significant relation with left caudate, and a near-significant trend with right thalamus volumes. In conclusion, our findings suggest that patients with CD have significantly smaller mean volumes of the left and right basal ganglia and smaller right thalamus, with a trend toward to smaller left thalamus compared to healthy controls and that these findings provide novel constraints for a modern psychobiological theory of hysteria.     

中国人脑黑质立体定向数字化解剖图谱的研究

目的探讨建立立体定向MRI黑质数字化、可视化图谱的可行性,为立体定向功能神经外科提供解剖学依据。方法健康中国自愿者150人,在标准的立体定向空间内进行全脑扫描,测量黑质体积。选取其中30例利用eFilm软件对黑质中心点坐标进行测量。随机选取1名自愿者,利用其成像数据,对黑质进行三维重建,并对其进行可视化、数字化处理。结果黑质的平均体积左侧为（327．26±24．19）mm3,右侧为（307．28±25．11）mm3,左右侧黑质的体积存在显著性差异（P〈0．05）。黑质中央截面的中心点坐标X、Y、Z分别为（8．45±0．69）mm、（一4．36±0．50）mm和（一9．47±0．80）mm,左右侧黑质的中心点坐标无显著性差异（P〉0．05）,性别之间黑质的中心点坐标亦无显著性差异（P〉0．05）。结论建立立体定向MRI黑质数字化、可视化图谱是可行的。