认知矫正治疗对精神分裂症患者脑白质弥散张量的影响_精品文档.ppt
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认知矫正治疗对精神分裂症患者脑白质弥散张量的影响_精品文档.ppt
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BraineffectsofComputerizedCognitiveRemediationTherapyinschizophrenia:
aDiffusionTensorImagingstudyThesisdefenseformastersdegreeofclinicalpsychiatryContents1、Introduction2、Methods3、Results4、Discussion5、Conclusion6、Limitations1、IntroductionvCognitiveimpairmentisoneofthecoresymptomsofSZ.1vCRTwasprovedtobeaneffectivewayforcognitivedeficits.2vMRIstudiesshowedthatCRTcanimprovebrainactivityandgraymattervoluminpatientswithSZ.1.KeefeRSE,FentonWS.HowshouldDSM-Vcriteriaforschizophreniaincludecognitiveimpairment?
J.Schizophreniabulletin,2007,33(4):
912-920.2.BellM,FiszdonJ,GreigT,etal.Neurocognitiveenhancementtherapywithworktherapyinschizophrenia:
6-monthfollow-upofneuropsychologicalperformanceJ.JournalofRehabilitationResearch&Development,2007,44(5).CRTimprovedbrainactivities33.BorJ,BrunelinJ,dAmatoT,etal.Howcancognitiveremediationtherapymodulatebrainactivationsinschizophrenia?
:
AnfMRIstudyJ.PsychiatryResearch:
Neuroimaging,2011,192(3):
160-166.CRTimprovedgraymattervolum44.EackSM,HogartyGE,ChoRY,etal.Neuroprotectiveeffectsofcognitiveenhancementtherapyagainstgraymatterlossinearlyschizophrenia:
resultsfroma2-yearrandomizedcontrolledtrialJ.ArchivesofGeneralPsychiatry,2010,67(7):
674.vThelimitationsofCRT.vTherelationshipbetweenCRTandCCRT.vBothCCRTandCRTCansignificantlyimprovecognitivefunctionsofpatientswithSZ.55.TANShu-ping,ZOUyi-zhuang,WANGJian,etal.Effectsofcognitiveremediationtherapyandcomputerizedcognitiveremediationtherapyoncognitivedeficitsinpatientswithschizophrenia:
arandomizedcontrolledstudyJ.ChinJpaychiatry,2010,43(3):
140-145.So,canCCRTalsocontributestobrainchanges?
vDTIistheonlynon-invasivemethodforcharacterisingthemicrostructuralorganizationofwhitematterintegrityinvivo.6vFAisthemainparameterofDTIthatispositivelycorrelatedwithwhitemyelinintegrity、axonsdensityandparallelity.6.JonesDK,LeemansA.DiffusiontensorimagingM/MagneticResonanceNeuroimaging.HumanaPress,2011:
127-144.vPreviousstudieshaveshownthatpatientswithSZexhibitareducedFAinbroadbrainregions,suchasspleniumandgenuofcorpuscallosum、anteriorcingulate、superiorandmiddlecerebellarpeduncle.7.8vThereducedFAoftheseregionswerecorrelatedwithcognitiveimparement.7.87、MagnottaVA,AdixML,CaprahanA,etal.Investigatingconnectivitybetweenthecerebellumandthalamusinschizophreniausingdiffusiontensortractography:
apilotstudyJ.PsychiatryResearch:
Neuroimaging,2008,163(3):
193-200.8、WANGYing,JIAYan-bing,LingXue-ying,etal.DiffusiontensorimaginginpatientswithfirstepisodicschizophreniaJ.ChinJPsychiatry,2008,41
(2):
73-76.Sowecometothehypothesis:
WehypothesisedthatCCRTcanimprovecognitivefunctioninSZpatients,atthesametimeitwillmaketheFAofthoseregionsincreasing.2、MethodsProcedures:
Participants:
Patientgroup:
vInclusioncriteria:
1)MetDSM-IVcriteriaforSZ;2)Long-termhospitalizationinpatients;3)Agebetween20y40y;4)Edu9y;5)MMSE27.vExclusioncriteria:
Allsubjectsincludedheadtrauma,substanceabuse,ormedicalorneurologicillnessthatmightaffectimagingmeasureswereexcluded.Healthycontrol:
1)Matchedwithpatientgroupinsex、age、Edu;2)Nomentalornervediseasesintheirrelatives;3)Exclusioncriteriawasthesame.vMRIscanning(GESigna3.0T)vPsychologicaltests:
Positiveandnegativesyndromescale,PANSSMini-MentalStateExamination,MMSETrailMakingTest,TMTHopkinsVerbalLearningTest一Revised,HVLT-RWisconsinCardSortingTest,WCSTDigitSpanTest,DSContinuousPerformanceTest,CPTvCCRT:
HealthmenCCRTwasusedhere,itcontainscognitiveshifting、workingmemory、plantraining、socialcognition.vTrainingperiods:
6M3/W30Min.vDTIdataanalysis:
DICOM2NiiandDTI-Studiovstatisticalandanalysis(SPSS12.0):
Firstly,homogeneitytestofvarianceandnormalitytestwereperformed.Thanttestwasperformedtocomparedthedifferencesbetweenandwithingroup.(P0.05)3、ResultsNote:
Redstandsforright-left,greenstandsforforward-backward,bluestandsforup-down.4.DiscussionvCCRTandcognitivefunctionCCRTisaneffectivewayforcognitivedeficits.CRTcanprotectthefunctionthathaventbeendestroyed.9SowebelieveCCRTcanbeapreventivemeasureforcognitiveimpairmentinSZ.9、EackS,GreenwaldD,HogartyS,etal.Cognitiveenhancementtherapyforearly-courseschizophrenia:
effectsofatwo-yearrandomizedcontrolledtrialJ.PsychiatricServices,2009,60(11):
1468-1476.vCCRTandPANSSCCRTrarelyeffectspsychiatrysymptoms.10Ifthecourseoftreatmentlastslongenough,theeffectswillappear.1110、DickinsonD,TenhulaW,MorrisS,etal.ARandomizedControlledTrialofComputer-AssistedCognitiveRemediationforSchizophrenia.AmJPaychiatry,2009,167
(2):
170-180.11、EackSM,RaquelleI.Mesholam-gately,DeborahP.Greenwald,etal.Negativesymptomimprovementduringcognitiverehab
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