摘要目的 探索精神病风险综合征人群在静息状态下早期的脑功能异常情况.方法 对17例精神病风险综合征的受试者(精神病风险综合征组)及与其相匹配的16例首次发作精神分裂症患者(首次发作精神分裂症组)和18名健康对照(对照组)进行静息态fMRI检查,应用ReHo方法处理数据,3组间方差分析有差异的脑区进行组间两两比较;使用PANSS进行精神症状严重程度评定,并对有差异的脑区局部一致性(ReHo)值与精神症状进行相关分析.结果 与对照组相比,精神病风险综合征组ReHo增高的脑区在左眶部额下回(ReHo值:0.96与0.77,P=0.000)、右海马(ReHo值:0.84与0.67,P=0.002),ReHo降低的脑区在左内侧额上回(ReHo值:1.27与1.44,P=0.034)、右角回(ReHo值:1.44与1.69,P=0.002)、右额中回和额上回(ReHo值:1.14与1.39,P=0.002);首次发作精神分裂症组ReHo增高的脑区在右海马(ReHo值:0.88与0.67,P=0.000)、左豆状核(ReHo值:1.02与0.80,P=0.000)、左三角部和岛盖部额下回(ReHo值:1.03与0.85,P=0.000),ReHo降低的脑区在左内侧额上回(ReHo值:1.08与1.44,P=0.000)、右颞上回(ReHo值:1.02与1.32,P=0.000)、右楔前叶(ReHo值:1.30与1.63,P=0.000)、右角回(ReHo值:1.37与1.69,P=0.000)、右额中回和额上回(ReHo值:1.05与1.39,P=0.000)、右额上回(ReHo值:0.94与1.27,P =0.000).精神病风险综合征组PANSS总分和阳性症状分均与右额中回和额上回呈负相关(r=-0.657,P＜0.01;r=-0.535,P ＜0.05);首次发作精神分裂症组PANSS总分与右额上回呈负相关(r=-0.606,P＜0.05),阴性症状分与右额上回、右楔前叶负相关(r=-0.541,P＜0.05;r=-0.524,P＜0.05),一般症状分与右颞上回、右额上回呈负相关(r=-0.534,P＜0.05;r=-0.548,P＜0.05).结论 精神病风险综合征存在脑功能ReHo的异常,并且异常区域比精神分裂症少.ReHo的异常改变有助于对精神分裂症早期的病理机制更好地理解.

abstractsObjective To explore whether abnormal brain activities exist in psychosis risk syndrome during resting state by fMRI technique and regional homogeneity(ReHo) approach.Methods fMRI images in resting state were obtained from 17 subjects with psychosis risk syndrome distinguished by Structured Interview for Prodromal Syndromes (SIPS),16 patients with first-episode schizophrenia according to the DSM-Ⅳ criteria and 18 healthy control subjects,and analyzed using ReHo approach.According to the results of ANOVA,the correlation analysis between the score of Positive and Negative Syndrome Scale (PANSS) and the significant difference brain regions ReHo was conducted.Results Compared with controlsubjects,psychosis risk syndrome group showed increased ReHo in the regions including the left pars orbitalis gyri frontalis inferiois (ReHo value:0.96 vs.0.77,P =0.000) and the right hippocampus (ReHo value:0.84 vs.0.67,P =0.002) ;decreased ReHo in the regions including the left medial superior frontal gyrus(ReHo value:1.27 vs.1.44,P =0.034),the right angular gyrus (ReHo value:1.44 vs.1.69,P =0.002) and middle/superior frontal gyrus (ReHo value:1.14 vs.1.39,P =0.002).Patients with first-episode schizophrenia showed increased ReHo in the regions including the right hippocampus (ReHo value:0.88 vs.0.67,P =0.000),the left putamen (ReHo value:1.02 vs.0.80,P =0.000) and pars triangularis/opercularis gyri frontalis inferiois (ReHo value:1.03 vs.0.85,P =0.000),and decreased ReHo in the regions including the left medial superior frontal gyrus (ReHo value:1.08 vs.1.44,P =0.000),the right precuneus(ReHo value:1.02 vs.1.32,P =0.000),superior temporal gyrus(ReHo value:1.30 vs.1.63,P =0.000),angular gyrus (ReHo value:1.37 vs.1.69,P =0.000),middle/superior frontal gyrus (ReHo value:1.05 vs.1.39,P =0.000) and superior frontal gyrus (ReHo value:0.94 vs.1.27,P =0.000).Within the psychosis risk syndrome group,the PANSS total score and positive symptom score was negatively correlated with the ReHo in right middle/superior frontal gyrus (r =-0.657,P ＜ 0.01 ; r =-0.535,P ＜ 0.05).Within the schizophrenia group,total score of PANSS was negatively correlated with ReHo in the right superior frontal gyrus (r =-0.606,P ＜ 0.05),and the negative symptom score was negatively correlated with ReHo in the right superior frontal gyrus and precuneus (r =-0.541,P ＜ 0.05;r =-0.524,P ＜ 0.05),and the common score was negatively correlated with ReHo in the right superior frontal gyrus and superior temporal gyrus(r =-0.534,P ＜ 0.05 ; r =-0.548,P ＜ 0.05).Conclusions Abnormal brain activities during resting state might exist in subjects with psychosis risk syndrome,which could be helpful for exploring the pathological mechanisms of early schizophrenia.