中文摘要：

目的 探讨首次发病未用药精神分裂症患者抗精神病药治疗前后静息态脑功能低频振幅变化特征及其与临床症状的关系.方法 对符合入组标准的21例首次发病未用药精神分裂症患者（精神分裂症组;分别在药物治疗前及口服第2代抗精神药治疗3个月后）以及性别、年龄、受教育程度相匹配的25名健康志愿者（对照组）进行静息态脑fMRI扫描,计算全脑低频振幅值;同期采用大体功能评定量表（Global Assessment of Functioning Scale,GAF）和PANSS量表对精神分裂症组患者的临床症状进行评估;采用Pearson线性回归分析精神分裂症组脑功能改变与临床症状的相关性.结果 （1）精神分裂症组治疗后GAF和PANSS总分、阳性症状分、阴性症状分、一般精神病理分与治疗前比较差异有统计学意义（t=6.45、5.13、3.98、3.29、4.32,均P＜0.01）.（2）与对照组比较,精神分裂症组低频振幅降低的脑区主要分布于左侧中央旁小叶、左侧枕上回/双侧距状回和楔叶、左侧枕中回、右侧岛叶,升高的脑区主要分布于前扣带回和右侧豆状核（未校正,t=-4.91、-4.30、-4.18、-3.59、3.60、3.44,均P＜0.01,体素数目＞10）.（3）与治疗前比较,精神分裂症组治疗后低频振幅升高的脑区位于双侧楔叶,降低的脑区位于左侧前扣带回（未校正,t=3.91、-4.42,P＜0.01,体素个数＞10）.（4）前扣带回低频振幅值与PANSS阴性症状分呈正相关（r=0.594,P=0.005）,左侧枕中回与PANSS总分呈负相关（r=-0.464,P=0.034）.结论 精神分裂症患者存在多个脑区的功能异常,前扣带回及枕叶与精神分裂症症状有关,且可能是抗精神病药的作用脑区.

英文摘要：

 Objective To explore the abnormalities of amplitude of low-frequency fluctuation （ALFF） in the resting-state functional magnetic resonance imaging （rs-fMRI） of first-episode medication-naive schizophrenia before and after antipsychotic drugs therapy,the correlation between brain activity and clinical syndromes was to be analyzed.Methods This prospective study was approved by the local ethical conmnittee,and written informed consent was obtained from all participants.21 antipsychotic-naive first-episode patients with schizophrenia and 25 healthy individuals were recruited and underwent resting-state functional MR imaging.The patients were re-scanned at the end of 3 months after the antipsychotic treatment.The differences of ALFF between patients and controls were analyzed with two-sample t test,the differences of ALFF in patients before and after antipsychotic drugs therapy were analyzed with two-sample t test.Results （1） The scores of Global Assessment of Functioning Scale,PANSS total score,PANSS positive score,PANSS negative score and PANSS general psychopathology score were significantly improved after antipsychotic drugs therapy （t=6.45,5.13,3.98,3.29,4.32;P〈0.01）.（2） Compared with the healthy controls,resting-state ALFF in schizophrenia patients significantly decreased in left paracentral lobule（PCL）,left superior occipital gyrus（SOG）/bilateral calcarine/cuneus,middle occipital gyrus（MOG）,and right insula （uncorrected,t=-4.91,-4.30,-4.18,-3.59;P〈0.01,cluster voxels〉10）,resting-state ALFF in schizophrenia patients significantly increased in anterior cingulate cortex （ACC） and right lentiform nucleus （uncorrected,t=3.60,3.44;P〈0.01,cluster voxels〉10）.（3） After antipsychotic drugs therapy for 3 months,the ALFF values increased in bilateral cuneus and decreased in left ACC compared with baseline（uncorrected,t=3.91,-4.42;P〈0.01,cluster voxels〉10）.（4） The ALFF values in the anterior cingulate cortex（ACC） at baseline were positively corr