抗精神病药物治疗精神分裂症对静息态脑功能网络节点度中心度的影响研究

目的　应用基于体素的节点度中心度（DC）技术探讨精神分裂症（SZ）患者经单一抗精神病药物治疗后静息态下脑功能网络连接属性的改变。方法　选取2011年2月—2014年7月在北京大学第六医院门诊及住院治疗的SZ患者38例为SZ组，同时期通过广告招募北京市社区健康志愿者31例为正常对照组。于基线时、随访6周后评估受试者精神症状及认知功能，采用阳性与阴性症状量表（PANSS）评估患者临床症状，行静息态功能磁共振成像扫描，计算全脑DC值，检测基线时SZ组与正常对照组、SZ组基线时与单一抗精神病药物治疗6周后DC值存在差异的脑区，并与精神症状及认知功能做偏相关分析。结果　基线时SZ组双侧中央后回、右侧扣带回、右侧丘脑、左侧小脑、双侧舌回的DC值低于正常对照组〔错误发生率（FDR）矫正，P<0.05〕；左侧中央后回DC值与阳性症状因子得分呈负相关（r=-0.361，P=0.033）。SZ组治疗6周后双侧中央后回DC值高于基线时（FDR未矫正，P<0.001）；右侧中央后回（z=48 mm）DC值与首次发病年龄呈正相关（r=0.484，P=0.003），与总病程呈负相关（r=-0.491，P=0.003）。结论　抗精神病药物治疗能改善SZ患者静息态脑功能网络连接的异常，中央后回可能是抗精神病药物作用的重要脑区。

Changes in the Degree Centrality in the Network Node of Resting State Brain Function after Antipsychotic Treatment in Schizophrenia

Objective　To investigate the change in connectivity properties of resting brain function in patients with schizophrenia （SZ） after treatment with a single antipsychotic by using a voxel level degree centrality （DC）-based method.Methods　In this study 38 patients with SZ who were treated as outpatients and inpatients at the Peking University Sixth Hospital from February 2011 to July 2014 were selected as the SZ group.At the same time，31 healthy volunteers from the community were recruited through advertisements and served as the normal control group.Participants were assessed for psychiatric symptoms and cognitive function at baseline and after 6 weeks of follow-up.Positive and Negative Symptom Scales were used to assess the clinical symptoms of the patients.Resting state functional magnetic resonance imaging scans were performed to calculate the total brain DC values.The difference in brain area between the SZ group and the normal control group at baseline，and between at baseline and 6 weeks after treatment with a single antipsychotic drug in the SZ group were detect，and the partial correlation analysis was made with the mental symptoms and cognitive function. Results　At baseline，the DC values in the bilateral central posterior gyrus，right cingulate gyrus，right thalamus，left cerebellum，and bilateral tongue spurs in the SZ group were lower than the normal control group 〔false discovery rate （FDR） correction，P<0.05〕.There was a negative correlation between the DC value in the left postcentral gyrus and the score of positive symptom factors （r=-0.361，P=0.033）.After 6 weeks of treatment，the DC value in the bilateral central posterior gyrus was higher in the SZ group than at baseline （FDR uncorrected，P<0.001）. The DC value in the right central posterior gyrus （z=48 mm） was positively correlated with the age of first onset （r=0.484，P=0.003），and negatively correlated with the total disease duration （r=-0.491，P=0.003）.Conclusion　Antipsychotic treatment can improve the abnormal connectivity of resting state brain function in patients with SZ，and the central posterior gyrus may be an important brain area for antipsychotic.