KR20210154125A - Program recording medium for analyzing fractional anisotropy of magnetic resonance imaging images to provide information on the prognosis prediction of panic disorder - Google Patents

Abstract

The present invention relates to a method for analyzing a magnetic resonance imaging image for providing information on prognosis prediction of a neurotic panic disorder, which comprises: a step of calculating the fractional anisotropy (FA) from the magnetic resonance imaging image for an individual brain tissue; and a step of comparing the calculated FA with the FA of a control group. The method can provide an individually customized optimal medical service by classifying a high-risk panic disorder requiring in-depth management.

Description

Program recording medium for analyzing fractional anisotropy of magnetic resonance imaging images to provide information on the prognosis prediction of panic disorder

It relates to a method of analyzing magnetic resonance imaging images to provide information about the prognosis of panic disorder.

Panic disorder is one of the anxiety disorders in which severe anxiety attacks and various accompanying physical symptoms occur suddenly without any warning. Panic disorder is a universal disorder irrespective of education level, personality traits, race or culture, and although it is a growing trend among modern people, the exact cause is still unknown. The complex factors that cause panic disorder include neurobiological, genetic and psychosocial factors.

Methods for treating panic disorder include drug therapy and cognitive behavioral therapy, but panic disorder induced by certain factors among the factors that cause panic disorder tends to have a poor prognosis by drug therapy and cognitive behavioral therapy.

Although more careful and delicate management is required for patients with specific panic disorder induced by certain factors and with a poor prognosis, the existing technology uses heart rate variability to differentiate panic disorder or measure the degree of panic disorder. Although the method was used, it is difficult to determine the degree of panic disorder using only HRV, so studies on these patients are still insufficient (Korean Patent Application Laid-Open No. 10-2016-0035318, Korean Patent No. 10-2152957, etc.).

One aspect comprises the steps of calculating a fractional anisotropy (FA) value from a magnetic resonance imaging image of a brain tissue of an individual; and

comparing the calculated split anisotropy with the split anisotropy of a control group; It is to provide a method of analyzing a magnetic resonance imaging image to provide information for predicting the prognosis of panic disorder, including a.

In order to solve the above problem, one aspect comprises the steps of calculating a fractional anisotropy (FA) value from a magnetic resonance imaging image of an individual's brain tissue; and comparing the calculated split anisotropy with the split anisotropy of a control group; It provides a method of analyzing magnetic resonance imaging images to provide information for predicting the prognosis of panic disorder, including.

The term “white matter” is a part of the brain where myelinated axons are gathered, and may refer to an opaque white area when viewed with the naked eye. The white matter is the brain head (insula), the corpus callosum (corpus callosum), the ventricle barrier (cerebral / ventricle tapetum), the cerebral arch / fibrous cord (fornix / stria terminalis), internal capsule (internal capsule), thalamic radiation (thalamic radiation), medial thalamic layer (sagittal striatum) and may include a posterior corona radiata. In the white matter, axons are arranged in a certain direction, so that water molecules are diffused in a certain direction, and anisotropy and directionality may exist.

The term “split anisotropy” may refer to an image mapped by calculating the diffusion coefficient for each direction from the diffusion tensor magnetic resonance image for each chemical niche and evaluating the structural linkage of proteins. The diffusion tensor magnetic resonance image may mean that a diffusion gradient is applied in six different directions and diffusion images are obtained in each direction. The division anisotropy may be obtained by calculating the diffusion coefficient for each direction for each chemical locus by using various computer programs.

The term “prognosis” refers to patient survival rate, disease progression, medication ?? It is a medical term indicating the effect of treatment and prediction of recovery.

The analysis method is performed in a system using a computer.

In one embodiment, when the calculated split anisotropy value is higher than that of the control group, the method further comprises determining the subject as a high-risk panic disorder group. Provides information on predicting the prognosis of panic disorder In order to do this, it is a method of analyzing magnetic resonance imaging images.

The term “control group” may refer to a general panic disorder group distinct from the high-risk panic disorder group herein. The control group had no history of sexual trauma and showed a lower degree of split anisotropy than the high-risk panic disorder group.

The term “high-risk panic disorder group” may mean a patient with a history of sexual trauma, and neuroticism may be intensified compared to the control group. The high-risk panic disorder group may refer to panic disorder patients who are more susceptible to symptoms caused by panic disorder and have poorer prognosis for drug treatment and cognitive behavioral therapy than the control group.

The neuroticism refers to the degree to which an individual exhibits negative emotional reactions such as discomfort, threats, frustration, and loss to a certain situation. Neuroticism is measured as a subscale of neuroticism in the Neuroticism-Extraversion-Openness (NEO) personality dimension test, and it can be said that the higher the total score, the higher the neurotic tendency.

The sexual trauma may mean psychological damage that occurs as a result of traumatic experiential events related to sexual acts, such as sexual assault, sexual assault, and sexual harassment. Preferably, the sexual trauma may be an early sexual trauma that occurs before adolescence. The above-mentioned sexual trauma is measured as the sum of the number of questions that answered 'yes' to the questions indicating the experience of sexual trauma on the Self-Reported Early Trauma Inventory Self Report-Short Form (ETISR-SF), and 'Yes' It can be said that the higher the number of questions answered, the greater the exposure to sexual trauma in the early life.

In one embodiment, the high-risk panic disorder group is a method of analyzing a magnetic resonance imaging image to provide information about the prognosis of panic disorder, which is a neurosis intensified compared to the control group.

In one embodiment, the high-risk panic disorder group is a method of analyzing magnetic resonance imaging images to provide information about the prognosis of panic disorder, which is a patient with a history of sexual trauma.

In one embodiment, the subject is a mammal, including a human, method of analyzing a magnetic resonance imaging image to provide information about the prognosis of panic disorder. to be. The subject is an individual in need of the prevention or treatment of panic disorder, and not only humans, but also non-humans such as monkeys, dogs, cats, rabbits, guinea pigs, rats, mice, cattle, sheep, pigs, goats, etc. It may be any individual, such as animals, birds, and fish, but is not limited thereto.

In one embodiment, the brain tissue is a ventricular wall plate (cerebral = ventricle tapetum), which is a method of analyzing a magnetic resonance imaging image to provide information about the prognosis of panic disorder.

In one embodiment, the magnetic resonance imaging image is a diffusion tensor image (diffusion tensor image), the information providing method for predicting the prognosis of panic disorder.

A method of analyzing magnetic resonance imaging images is provided to provide information on the prognosis of panic disorder. The above information providing method can classify the high-risk panic disorder group with a history of early sexual trauma and deep neurosis, and the high-risk panic disorder group has a poor prognosis for drug treatment and cognitive behavioral therapy, so more in-depth medical services can prevent the exacerbation of the disease.

BRIEF DESCRIPTION OF THE DRAWINGS It is a figure which shows the area|region of the ventricular wall plate in the brain in 3D slice.
FIG. 2 is a diagram showing a parietal ventricle region having a segmented anisotropy value showing a significant positive correlation with the degree of early trauma experience among white matter regions of a high-risk panic disorder patient.
3 is a diagram showing the correlation between the degree of division anisotropy of the region shown in FIG. 2 and the degree of early sexual trauma experience.
4 is a diagram showing the correlation between the segmentation anisotropy and the NEO-N score in high-risk panic disorder patients.

Advantages and features, and how to achieve them, will become apparent with reference to the embodiments described in detail in conjunction with the accompanying drawings. However, it is not limited to the embodiments presented below, but may be implemented in a variety of different forms, and should be understood to include all transformations, equivalents, and substitutes included in the spirit and scope of the technology. The embodiments presented below are provided so that the disclosure is complete, and to fully inform those of ordinary skill in the art the scope of the invention. In the description of the present specification, if it is determined that a detailed description of a related known technology may obscure the gist of the present invention, the detailed description thereof will be omitted.

The terms used herein are used only to describe specific embodiments, and are not intended to limit the present specification. The singular expression includes the plural expression unless the context clearly dictates otherwise. In the present application, terms such as “comprises” or “have” are intended to designate that a feature, number, step, operation, component, part, or combination thereof described in the specification exists, but one or more other features It should be understood that this does not preclude the existence or addition of numbers, steps, operations, components, parts, or combinations thereof. Terms such as first, second, etc. may be used to describe various elements, but the elements should not be limited by the terms. The above terms are used only for the purpose of distinguishing one component from another.

[Test subject]

Selection of patient groups

The subjects of this study were 70 patients with panic disorder (33 men, 37 women, age 37.90 ± 12.22 years) from the Department of Psychiatry, CHA Hospital, Bundang. The patients were between the ages of 17 and 65, Korean, right-handed. Schizophrenia, bipolar disorder, anxiety disorders other than panic disorder, substance abuse, mental retardation, serious medical or neurological disorders, pregnancy or brain MRI were excluded from the study subjects. Self-reported Early Trauma Inventory Self Report-Short Form (ETISR-SF), Neuroticism-Extraversion-Openness Personality Inventory-Neuroticism (NEO-N), Panic for the above patients The Panic Disorder Severity Scale (PDSS), Beck Anxiety Inventory (BAI) and Beck Depression Scale-II (BDI-II; Beck Depression Inventory-II) were measured.

The statistical characteristics of the test subjects are as shown in Table 1 below.

PD (n=70) (Gender Male Female 33 of 37 Age (years, Mean ± SD) 37.90 ± 12.22 Duration of training (years, mean ± SD) 14.15 ± 2.89 Duration of illness (months, mean ± SD) 45.27 ± 77.59 Cranial internal volume (ml, mean ± SD) 1534.31 ± 166.34 Baseline ETISR-SF Total Score (mean ± SD) 4.95 ± 4.24 Baseline NEO-N Total Score (mean ± SD) 24.96 ± 6.51 Types of SSRIs (escitalopram (n (%)) / paroxetine (n (%))) 20 (28.6) / 26 (37.1) SSRI equivalent dose (mg, mean ± SD)a 7.39 ± 6.92 Types of benzodiazepines (alprazolam (n (%)) / clonazepam (n (%))) 51 (72.9) / 17 (24.3) Benzodiazepine equivalent dose (mg, mean ± SD) 1.86 ± 2.19

[Example]

Example 1: Acquisition of MRI images

In order to acquire MRI images of the subjects, the 3-Tesla GE Signa HDxt scanner (GE Healthcare, Milwaukee, WI, USA) was used for imaging at CHA Bundang Hospital. Specifically, after instructing the subjects not to move their eyes in a stable state in the MRI scanner, 3D diffusion tensor images were obtained. Using the echo-planar imaging sequence, 70 slices with ^{diffusion emphasis of b = 900 sec/mm 2} in 51 directions, and 8 basal slices with diffusion emphasis of b = 0 sec/mm ² in 51 directions for diffusion emphasis of the brain image (diffusion-weighted image; TR=17,000 ms; TE=108 ms; field-of-view=240 mm; matrix=144 × 144; voxel size=1.67 × 1.67 × 1.7 mm ³ ; approximate scan time=17 minutes) was obtained. The diffusion-weighted image thus obtained was calculated using the least-squares method and converted into a diffusion tensor image.

Example 2: Pretreatment process

The image obtained in Example 1 was preprocessed using Functional MRI of the Brain (FMRIB) Software Library (FSL version 5.0; Oxford, UK; https://fsl.fmrib.ox.ac.uk/fsl/) . Specifically, skull stripping, Eddy current correction, segmentation anisotropy image generation through tensor model fitting, and FMRIB's Nonlinear Image Registration Tool (FNIRT) were used to determine the size and location of the brain in a standard brain space. Skeletonization of the white matter pathway was performed in the registration and overall mean segmented anisotropy images.

Example 3: Measurement and Statistics of Split Anisotropy of Panic Disorder Patients

In order to measure the anisotropy (FA value) of the ventricular parietal plate in patients with panic disorder, the following experiment was conducted. The region of interest of the ventricular wall plate was extracted using a 3D slicer, and voxel-level statistical analysis of the diffusion tensor image data was performed using Tract-Based Spatial Statistics (TBSS).

There were no ventricular parietal plate regions with segmented anisotropy significantly correlated with the total ETI score. However, as shown in FIG. 2 , a region with segmental anisotropy significantly correlated with the score of early sexual trauma, a sub-item related to sexual trauma, was found in the right ventricular parietal plate. As shown in FIG. 3 , it was found that the greater the experience of early sexual trauma, the higher the division anisotropy of the region of FIG. 2 .

Also, as shown in Table 2 below, only early sexual trauma among early general trauma, early physical trauma, early emotional trauma, and early sexual trauma was found to have a significant correlation with the FA value of the ventricular barrier.

Ventricular barrier FA value early general trauma early physical trauma early emotional trauma early sexual trauma Pearson's correlation coefficient One 0.027 -.079 0.113 0.362

As a result of Exploratory Correlation Analysis, the history of early sexual trauma and the degree of neurosis were positively correlated with the FA value of the right ventricular parietal plate region shown in FIG. 2 ( FIG. 4 , p = 0.024). There was no significant correlation between the FA values of the ventricular barrier and the scores of PDSS, BAI and BDI-II. This suggests that the FA value of the right ventricular parietal plate region shown in FIG. 2 has a specific relationship with the neurotic tendency reflecting vulnerability to panic disorder rather than the severity of anxiety, depression, and panic symptoms themselves.

Therefore, it was found that panic disorder patients with high FA values had a history of early sexual trauma and had a more pronounced neurotic tendency. This was classified as a high-risk panic disorder group. In all panic disorder patients, the median value of the right ventricular parietal plate area was 0.7258. Based on this, panic disorder patients with FA values below the median value were classified as a control group.

The statistical characteristics of the control group and the high-risk panic disorder group are shown in Table 3 below. The high-risk panic disorder group was found to be younger than the control group (p = 0.044), suggesting that the onset of the disease may have started at a younger age in the high-risk panic disorder group. The high-risk panic disorder group had a significantly higher early sexual trauma experience than the control group (p < 0.001), and had a higher neuroticism (p = 0.005).

control high-risk panic disorder (Gender Male Female 19/16 14/21 Age (years, Mean ± SD) 40.38 ± 12.67 34.97 ± 11.18 Duration of training (years, mean ± SD) 14.06 ± 3.57 14.24 ± 2.08 Duration of illness (months, mean ± SD) 40.94 ± 69.19 49.60 ± 85.99 Cranial internal volume (ml, mean ± SD) 1538.83 ± 163.56 1529.80 ± 171.35 Ventricular wall plate FA values 0.7330 ± 0.0782 0.7985 ± 0.0217 Early Sexual Trauma Scale 0 ± 0 2.00 ± 1.04 Personality Dimension Test - Neuroticism 24.18 ± 6.18 29.75 ± 4.71

Claims (1)

A computer-readable recording medium recording a program for realizing each step,
The steps are
calculating the fractional anisotropy (FA) value of a cerebral ventricle tapetum from a magnetic resonance imaging image of the brain tissue of an individual with panic disorder;
comparing the calculated split anisotropy value with the split anisotropy value of a control group; and
When the calculated split anisotropy value is higher than the split anisotropy value of the control group, judging the individual as a high-risk panic disorder group with early sexual trauma; predicting a panic disorder prognosis, including As a computer-readable recording medium in which a program for executing a method for a computer to be executed is recorded,
The division anisotropy value is measured using TBSS (Tract-Based Spatial Statistics), a computer-readable recording medium.

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