中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2013, Vol. 8 ›› Issue (26): 2405-2414.doi: 10.3969/j.issn.1673-5374.2013.26.001

• 原著:脑损伤修复保护与再生 •    下一篇

创伤后应激障碍脑结构: 基于体素的形态学测量分析

  

  • 收稿日期:2013-06-04 修回日期:2013-08-03 出版日期:2013-09-15 发布日期:2013-09-15

Brain structure in post-traumatic stress disorder A voxel-based morphometry analysis

Liwen Tan1, Li Zhang1, Rongfeng Qi2, Guangming Lu2, Lingjiang Li1, Jun Liu3, 4, Weihui Li1   

  1. 1 Mental Health Institute of the Second Xiangya Hospital, Central South University, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Hunan Province Technology Institute of Psychiatry, Changsha 410011, Hunan Province, China

    2 Department of Medical Imaging, Jinling Hospital, Clinical School of Medical College, Nanjing University, Nanjing 210002, Jiangsu Province, China

    3 Department of Radiology, the Second Xiangya Hosipital, Central South University, Changsha 410011, Hunan Province, China

    4 School of Public Administration, Central South University, Changsha 410011, Hunan Province, China
  • Received:2013-06-04 Revised:2013-08-03 Online:2013-09-15 Published:2013-09-15
  • Contact: Weihui Li, M.D., Attending physician, Mental Health Institute of the Second Xiangya Hospital, Central South University, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Hunan Province Technology Institute of Psychiatry, Changsha 410011, Hunan Province, China, weihui_li@163.com.
  • About author:Liwen Tan, M.D., Associate professor. Liwen Tan and Li Zhang contributed equally to this work.
  • Supported by:

    Key Program for Guangming Lu, No. BWS11J063 and No.10z026.

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摘要：

首次采取基于体素的形态学测量（VBM）MRI形态学测量方法，比较大型矿难幸存的慢性创伤后应激障碍患者12例，创伤后应激障碍症状好转者7例以及经历相同矿难但未发生创伤后应激障碍的对照组14例的脑结构差异，分析脑结构差异与创伤后应激障碍症状之间的关系。结果提示，脑区灰质体积：慢性创伤后应激障碍患者<症状好转组<创伤正常对照组。组间比较：慢性创伤后应激障碍患者组与症状好转组相比，右侧枕叶舌回灰质体积减小；症状好转组与创伤对照组相比，右侧枕中回、左侧额中回灰质体积减小；慢性创伤后应激障碍患者组与创伤对照组相比，左侧顶上小叶、右侧额上回灰质体积减小。创伤后应激障碍患者组和症状好转组左顶上小叶灰质体积与状态-特质焦虑问卷分量表特质焦虑问卷评分呈明显正相关（r=0.477, P=0.039）。说明（1）慢性创伤后应激障碍患者存在前额叶、枕叶、顶叶脑区的灰质结构损害。（2）创伤后应激障碍症状好转后结构损害虽有所减轻，但仍达不到非创伤后应激障碍对照的水平。（3）顶上小叶可能与创伤后应激障碍的慢性化有关。创伤后应激障碍患者确实存在脑灰质的异常。

关键词: 神经再生, 神经影像, 磁共振成像, 创伤后应激障碍, 基于体素的形态学测量, 前额叶, 顶叶, 枕叶, 随访, 基金资助文章

Abstract:

This study compared the difference in brain structure in 12 mine disaster survivors with chronic post-traumatic stress disorder, 7 cases of improved post-traumatic stress disorder symptoms, and 14 controls who experienced the same mine disaster but did not suffer post-traumatic stress disorder, us-ing the voxel-based morphometry method. The correlation between differences in brain structure and post-traumatic stress disorder symptoms was also investigated. Results showed that the gray matter volume was the highest in the trauma control group, followed by the symptoms-improved group, and the lowest in the chronic post-traumatic stress disorder group. Compared with the symptoms-improved group, the gray matter volume in the lingual gyrus of the right occipital lobe was reduced in the chronic post-traumatic stress disorder group. Compared with the trauma control group, the gray matter volume in the right middle occipital gyrus and left middle frontal gyrus was reduced in the symptoms-improved group. Compared with the trauma control group, the gray matter volume in the left superior parietal lobule and right superior frontal gyrus was reduced in the chronic post-traumatic stress disorder group. The gray matter volume in the left superior parietal lobule was significantly positively correlated with the State-Trait Anxiety Inventory subscale score in the symptoms-improved group and chronic post-traumatic stress disorder group (r = 0.477, P = 0.039). Our findings indicate that (1) chronic post-traumatic stress disorder patients have gray matter structural damage in the prefrontal lobe, occip-ital lobe, and parietal lobe, (2) after post-traumatic stress, the disorder symptoms are improved and gray matter structural damage is reduced, but cannot recover to the trauma-control level, and (3) the superior parietal lobule is possibly associated with chronic post-traumatic stress disorder. Post-traumatic stress disorder patients exhibit gray matter abnormalities.

Key words: neural regeneration, neuroimaging, MRI, post-traumatic stress disorder, voxel-based morphometry, pre-frontal lobe, parietal lobe, occipital lobe, follow-ups, grants-supported paper, neuroregeneration