創傷后應激障礙患者靜息態下腦功能局部一致性的研究_《華西醫學》

作者：

朱鴻儒 ¹ , 張俊然 ² , 邱昌建 ¹ , 武瑞芝 ¹ , 孟雅婧 ¹ , 崔豪飛 ¹ , 龔啟勇 ³ ,  張偉 ¹

四川大學（成都，610041）1 華西醫院心理衛生中心，2 電氣信息學院;3 華西醫院放射科華西磁共振研究中心;

關鍵詞：

創傷后應激障礙功能磁共振成像靜息狀態局部一致性地震

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目的　利用局部一致性（ReHo）方法探測創傷后應激障礙（PTSD）患者在靜息狀態下是否存在著大腦功能異常。方法　2010年5月－7月對18例未經治療的地震PTSD患者和19例同樣經歷地震但未患PTSD的對照者進行了靜息態功能磁共振成像（Rs-fMRI）掃描。應用ReHo方法處理Rs-fMRI數據，得出PTSD患者的異常腦區，并將患者存在組間差異的腦區ReHo值與臨床用PTSD診斷量表（CAPS）、漢密爾頓抑郁量表（HAMD）和漢密爾頓焦慮量表（HAMA）分別進行相關分析。結果　① PTSD組ReHo顯著增加的腦區包括右側顳下回、楔前葉、頂下葉、中扣帶回，左側枕中回以及左/右側后扣帶回；ReHo顯著降低的腦區包括左側海馬和左/右側腹側前扣帶回。② 異常腦區中后扣帶回和右側中扣帶回ReHo與HAMD呈負相關（中扣帶回r=?0.575，P=0.012；右側后扣帶回：r=?0.507，P=0.032），其余腦區ReHo與臨床指標無明顯相關性（P＞0.05），左側海馬與CAPS的相關性相對其他腦區較大（r=?0.430，P=0.075）。結論　PTSD患者在靜息狀態下即存在著局部腦功能活動的降低和增加，ReHo方法可能有助于研究PTSD患者靜息狀態腦活動。

引用本文： 朱鴻儒,張俊然,邱昌建,武瑞芝,孟雅婧,崔豪飛,龔啟勇,張偉. 創傷后應激障礙患者靜息態下腦功能局部一致性的研究. 華西醫學, 2012, 27(5): 641-646. doi: 復制

1.	Woon FL, Sood S, Hedges DW. Hippocampal volume deficits associated with exposure to psychological trauma and posttraumatic stress disorder in adults: a meta-analysis[J]. Prog Neuropsychopharmacol Biol Psychiatry, 2010, 34(7): 1181-1188.
2.	Lui S, Huang X, Chen L, et al. High-field MRI reveals an acute impact on brain function in survivors of the magnitude 8.0 earthquake in China[J]. Proc Natl Acad Sci USA, 2009, 106(36): 15412-15417.
3.	Robinson BL, Shergill SS. Imaging in posttraumatic stress disorder[J]. Curr Opin Psychiatry, 2011, 24(1): 29-33.
4.	Zang Y, Jiang T, Lu Y, et al. Regional homogeneity approach to fMRI data analysis[J]. Neuroimage, 2004, 22(1): 394-400.
5.	Shukla DK, Keehn B, Muller RA. Regional homogeneity of fMRI time series in autism spectrum disorders[J]. Neurosci Lett, 2010, 476(1): 46-51.
6.	Yuan YG, Zhang ZJ, Bai F, et al. Abnormal neural activity in the patients with remitted geriatric depression: a resting-state functional magnetic resonance imaging study[J]. J Affect Disord, 2008, 111(2-3): 145-152.
7.	Morgan VL, Price RR, Arain A, et al. Resting functional MRI with temporal clustering analysis for localization of epileptic activity without EEG[J]. Neuroimage, 2004, 21(1): 473-481.
8.	Etkin A, Egner T, Kalisch R. Emotional processing in anterior cingulate and medial prefrontal cortex[J]. Trends Cogn Sci, 2011, 15(2): 85-93.
9.	Straube T, Schmidt S, Weiss T, et al. Dynamic activation of the anterior cingulate cortex during anticipatory anxiety[J]. Neuroimage, 2009, 44(3): 975-981.
10.	Shin LM, Wright CI, Cannistraro PA, et al. A functional magnetic resonance imaging study of amygdala and medial prefrontal cortex responses to overtly presented fearful faces in posttraumatic stress disorder[J]. Arch Gen Psychiatry, 2005, 62(3): 273-281.
11.	Karl A, Schaefer M, Malta LS, et al. A meta-analysis of structural brain abnormalities in PTSD[J]. Neurosci Biobehav Rev, 2006, 30(7): 1004-1031.
12.	Geuze E, Vermetten E, Ruf M, et al. Neural correlates of associative learning and memory in veterans with posttraumatic stress disorder[J]. J Psychiatr Res, 2008, 42(8): 659-669.
13.	武瑞芝, 張俊然, 邱昌建, 等. 地震創傷后應激障礙患者腦靜息態默認網絡研究[J]. 四川大學學報(醫學版), 2011, 42(3): 397-400.
14.	Cavanna AE, Trimble MR. The precuneus: a review of its functional anatomy and behavioural correlates[J]. Brain, 2006, 129(Pt 3): 564-583.
15.	Hayes JP, Labar KS, McCarthy G, et al. Reduced hippocampal and amygdala activity predicts memory distortions for trauma reminders in combat-related PTSD[J]. J Psychiatr Res, 2011, 45(5): 660-669.
16.	Maddock RJ, Garrett AS, Buonocore MH. Posterior cingulate cortex activation by emotional words: fMRI evidence from a valence decision task[J]. Hum Brain Mapp, 2003, 18(1): 30-41.
17.	Bluhm RL, Williamson PC, Osuch EA, et al. Alterations in default network connectivity in posttraumatic stress disorder related to early-life trauma[J]. J Psychiatry Neurosci, 2009, 34(3): 187-94.
18.	Bush G, Luu P, Posner MI. Cognitive and emotional influences in anterior cingulate cortex[J]. Trends Cogn Sci, 2000, 4(6): 215-222.
19.	Milad MR, Quirk GJ, Pitman RK, et al. A role for the human dorsal anterior cingulate cortex in fear expression[J]. Biol Psychiatry, 2007, 62(10): 1191-1194.
20.	Derbyshire SW. Exploring the pain “neuromatrix”[J]. Curr Rev Pain, 2000, 4(6): 467-477.
21.	Shin LM, Lasko NB, Macklin ML, et al. Resting metabolic activity in the cingulate cortex and vulnerability to posttraumatic stress disorder[J]. Arch Gen Psychiatry, 2009, 66(10): 1099-1107.
22.	Hamilton JP, Chen G, Thomason ME, et al. Investigating neural primacy in Major Depressive Disorder: multivariate Granger causality analysis of resting-state fMRI time-series data[J]. Mol Psychiatry, 2011, 16(7): 763-772.
23.	Lanius RA, Williamson PC, Densmore M, et al. The nature of traumatic memories: a 4-T FMRI functional connectivity analysis[J]. Am J Psychiatry, 2004, 161(1): 36-44.
24.	黃清玲, 盧光明, 張志強, 等. 創傷后應激障礙靜息狀態下腦fMRI的研究[J]. 臨床放射學雜志, 2009, 28(6): 750-754.
25.	Bonne O, Gilboa A, Louzoun Y, et al. Resting regional cerebral perfusion in recent posttraumatic stress disorder[J]. Biol Psychiatry, 2003, 54(10): 1077-1086.
26.	Fischer KW. Dynamic cycles of cognitive and brain development: measuring growth in mind, brain, and education[M]//Battro AM, Fischer KW, Léna P. The educated brain. Cambridge: Cambridge University Press, 2008: 127-150.
27.	隋雙戈. 性侵害創傷干預模式, 性侵害PTSD患者心理社會因素及腦結構功能特征研究[D]. 長沙: 中南大學, 2010.
28.	謝晟, 肖江喜, 白靜, 等. 正常老年人無意義圖形記憶任務的fMRI研究[J]. 中國醫學影像技術, 2004, 20(4): 571-574.

1. 　Woon FL, Sood S, Hedges DW. Hippocampal volume deficits associated with exposure to psychological trauma and posttraumatic stress disorder in adults: a meta-analysis[J]. Prog Neuropsychopharmacol Biol Psychiatry, 2010, 34(7): 1181-1188.
2. 　Lui S, Huang X, Chen L, et al. High-field MRI reveals an acute impact on brain function in survivors of the magnitude 8.0 earthquake in China[J]. Proc Natl Acad Sci USA, 2009, 106(36): 15412-15417.
3. 　Robinson BL, Shergill SS. Imaging in posttraumatic stress disorder[J]. Curr Opin Psychiatry, 2011, 24(1): 29-33.
4. 　Zang Y, Jiang T, Lu Y, et al. Regional homogeneity approach to fMRI data analysis[J]. Neuroimage, 2004, 22(1): 394-400.
5. 　Shukla DK, Keehn B, Muller RA. Regional homogeneity of fMRI time series in autism spectrum disorders[J]. Neurosci Lett, 2010, 476(1): 46-51.
6. 　Yuan YG, Zhang ZJ, Bai F, et al. Abnormal neural activity in the patients with remitted geriatric depression: a resting-state functional magnetic resonance imaging study[J]. J Affect Disord, 2008, 111(2-3): 145-152.
7. 　Morgan VL, Price RR, Arain A, et al. Resting functional MRI with temporal clustering analysis for localization of epileptic activity without EEG[J]. Neuroimage, 2004, 21(1): 473-481.
8. 　Etkin A, Egner T, Kalisch R. Emotional processing in anterior cingulate and medial prefrontal cortex[J]. Trends Cogn Sci, 2011, 15(2): 85-93.
9. 　Straube T, Schmidt S, Weiss T, et al. Dynamic activation of the anterior cingulate cortex during anticipatory anxiety[J]. Neuroimage, 2009, 44(3): 975-981.
10. 　Shin LM, Wright CI, Cannistraro PA, et al. A functional magnetic resonance imaging study of amygdala and medial prefrontal cortex responses to overtly presented fearful faces in posttraumatic stress disorder[J]. Arch Gen Psychiatry, 2005, 62(3): 273-281.
11. 　Karl A, Schaefer M, Malta LS, et al. A meta-analysis of structural brain abnormalities in PTSD[J]. Neurosci Biobehav Rev, 2006, 30(7): 1004-1031.
12. 　Geuze E, Vermetten E, Ruf M, et al. Neural correlates of associative learning and memory in veterans with posttraumatic stress disorder[J]. J Psychiatr Res, 2008, 42(8): 659-669.
13. 　武瑞芝, 張俊然, 邱昌建, 等. 地震創傷后應激障礙患者腦靜息態默認網絡研究[J]. 四川大學學報(醫學版), 2011, 42(3): 397-400.
14. 　Cavanna AE, Trimble MR. The precuneus: a review of its functional anatomy and behavioural correlates[J]. Brain, 2006, 129(Pt 3): 564-583.
15. 　Hayes JP, Labar KS, McCarthy G, et al. Reduced hippocampal and amygdala activity predicts memory distortions for trauma reminders in combat-related PTSD[J]. J Psychiatr Res, 2011, 45(5): 660-669.
16. 　Maddock RJ, Garrett AS, Buonocore MH. Posterior cingulate cortex activation by emotional words: fMRI evidence from a valence decision task[J]. Hum Brain Mapp, 2003, 18(1): 30-41.
17. 　Bluhm RL, Williamson PC, Osuch EA, et al. Alterations in default network connectivity in posttraumatic stress disorder related to early-life trauma[J]. J Psychiatry Neurosci, 2009, 34(3): 187-94.
18. 　Bush G, Luu P, Posner MI. Cognitive and emotional influences in anterior cingulate cortex[J]. Trends Cogn Sci, 2000, 4(6): 215-222.
19. 　Milad MR, Quirk GJ, Pitman RK, et al. A role for the human dorsal anterior cingulate cortex in fear expression[J]. Biol Psychiatry, 2007, 62(10): 1191-1194.
20. 　Derbyshire SW. Exploring the pain “neuromatrix”[J]. Curr Rev Pain, 2000, 4(6): 467-477.
21. 　Shin LM, Lasko NB, Macklin ML, et al. Resting metabolic activity in the cingulate cortex and vulnerability to posttraumatic stress disorder[J]. Arch Gen Psychiatry, 2009, 66(10): 1099-1107.
22. 　Hamilton JP, Chen G, Thomason ME, et al. Investigating neural primacy in Major Depressive Disorder: multivariate Granger causality analysis of resting-state fMRI time-series data[J]. Mol Psychiatry, 2011, 16(7): 763-772.
23. 　Lanius RA, Williamson PC, Densmore M, et al. The nature of traumatic memories: a 4-T FMRI functional connectivity analysis[J]. Am J Psychiatry, 2004, 161(1): 36-44.
24. 　黃清玲, 盧光明, 張志強, 等. 創傷后應激障礙靜息狀態下腦fMRI的研究[J]. 臨床放射學雜志, 2009, 28(6): 750-754.
25. 　Bonne O, Gilboa A, Louzoun Y, et al. Resting regional cerebral perfusion in recent posttraumatic stress disorder[J]. Biol Psychiatry, 2003, 54(10): 1077-1086.
26. 　Fischer KW. Dynamic cycles of cognitive and brain development: measuring growth in mind, brain, and education[M]//Battro AM, Fischer KW, Léna P. The educated brain. Cambridge: Cambridge University Press, 2008: 127-150.
27. 　隋雙戈. 性侵害創傷干預模式, 性侵害PTSD患者心理社會因素及腦結構功能特征研究[D]. 長沙: 中南大學, 2010.
28. 　謝晟, 肖江喜, 白靜, 等. 正常老年人無意義圖形記憶任務的fMRI研究[J]. 中國醫學影像技術, 2004, 20(4): 571-574.

《華西醫學》

創傷后應激障礙患者靜息態下腦功能局部一致性的研究

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《華西醫學》

創傷后應激障礙患者靜息態下腦功能局部一致性的研究

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