摘要
目的 利用功能磁共振成像(fMRI)探讨首发精神分裂症患者利培酮治疗前后认知功能激发图像的特点。方法 18例首发精神分裂症患者治疗前进行倒背数字作业的fMRI检查,经利培酮[(3.8±0.9)mg/d]治疗(57±9)d后复查fMRI(16例)。用阳性和阴性症状量表(PANSS)及治疗中需处理的不良反应症状量表评价精神症状的严重程度及不良反应。结果 (1)利培酮治疗后的PANSS减分率为(50±22)％,有效率为72％。(2)治疗前倒背数字作业激活范围较广泛,包括额叶、顶叶及颞叶等脑区。(3)左侧额上回治疗前激活脑区计数为4,治疗后计数为12,治疗前后激活脑区计数的差异有非常显著性(P=0.009);左侧额叶腹外侧面治疗前激活平均体积为(15±38)个体素,治疗后激活平均体积为(67±76)个体素,治疗前后的差异有显著性(P=0.046)。结论 首发精神分裂症患者在发病初期就存在工作记忆缺陷,这种缺陷可能与左侧额上回及额下回激活低下有关,利培酮治疗可改善患者的工作记忆缺陷。
Objective To explore the characteristics of functional areas of backward digit span task (BDST) by using blood oxygenation level dependent functional magnetic resonance imaging (BOLD-fMRI) in first-episode schizophrenic patients before and after treatment. Methods Eighteen drug-naive patients met with the 10th edition of International Classification of Diseases criteria for schizophrenia were enrolled and fulfilled the fMRI. A block-design paradigm with 6 blocks was applied and the whole brain fMRI were collected as they performed a BDST task . After 8-week treatment of risperidone [ (3. 8±0. 9) mg/d] , 16 patients were re-examined. At the same time, the patients were assessed with the Positive and Negative Syndrome Scale ( PANSS) and Treatment Emergent Symptoms Scale. Results The patients had (50± 22)% reduction in their PANSS total scores after treatment and had efficacy rate of 72% . The areas activated by BDST task included bilateral prefrontal, parietal and temporal cortices in patients before treatment The activated areas in the left superior frontal gyrus were 4 before treatment, and increased to 12 after treatment (P = 0. 09). The activated volume in the left ventrolateral frontal cortex were (15±38) voxels pre-treatment and (67±76) voxels post-treatment (P = 0.046). Conclusions It is indicated that working memory deficit may exist during the early stage of schizophrenia, which may be related to hypofunction in left superior frontal gyrus and left inferior frontal gyrus. Risperidone can improve the working memory and activation in related brain areas.
出处
《中华精神科杂志》
CAS
CSCD
北大核心
2004年第2期81-84,共4页
Chinese Journal of Psychiatry
基金
杨森科学研究基金资助项目
