伴有和不伴抑郁的阿尔茨海默病患者在情感Stroop任务下脑功能激活差异的研究  

Different patterns of brain activation between patients of Alzheimer's disease with and without depression:a functional MRI study during emotion Stroop task

作　　者：王海涛[1] 贾建平[1] 

机构地区：[1]首都医科大学北京宣武医院神经内科,100053

出　　处：《中华医学杂志》2007年第13期885-888,共4页National Medical Journal of China

摘　　要：目的研究阿尔茨海默病(AD)与阿尔茨海默病伴抑郁(dAD)患者在情感 Stroop 任务下脑功能激活区的差异,探讨情感因素对 AD 伴抑郁的发病影响。方法收集临床诊断轻度 AD 患者20例(DSM-Ⅳ标准,CDR 1.0),其中9例 dAD 患者(NIMH-dAD 标准,CSDD 量表>12),其在年龄、性别、利手(右利)、教育程度、病程和 MMSE 评分等项上差异无统计学意义。另有10例正常老年人为对照组。采用功能磁共振成像(fMRI)方法,利用情感 Stroop 任务为刺激。计算完成任务的反应时间、错误率和漏报率为行为学指标,同时采集 fMRI 脑部功能图像,使用 SPM2软件分析。结果 dAD、AD 组与正常对照组完成情感 Stroop 任务的反应时间分别为1528 ms±302 ms、1173 ms±237 ms、875ms±320 ms;错误率分别为9.7%、7.6%、0.5%;漏报率分别为2.5%、3.1%、0,2组 AD 患者的反应时间均明显慢于正常对照组(均 P<0.001),且 dAD 组比 AD 组更慢(P=0.04),但2组在错误率(P=0.22)和漏报率(P=0.29)间差异无统计学意义。情感 Stroop 任务时(P<0.001),正常老年组在右侧杏仁核、双侧前额皮质、双侧枕叶与左侧顶叶激活。AD 组仅见双侧顶叶和左侧前额皮质少量激活。dAD 组双侧前额皮质激活。结论 AD 伴有和不伴抑郁的患者均存在异常的脑功能成像,并有着明显的差别。dAD 受情感因素的影响更大。与情感功能相关的神经纤维投射异常可能是 AD 伴抑郁的发病基础。Objective To examine whether emotional factor influences the depression onset in Alzheimer＇s disease （AD）. Methods Twenty mild AD patients conforming to the of DSM-lVcriteria with a clinical dementia rating score of 1.0 were divided into 2 groups ： 11 patients without depression （ AD group）, and 9 patients with depression confirming to the National Institute of Mental Health-dAD criteria with a Cornell scale for depression in dementia score 〉 12 （dAD group）, without significant differences in age, gender, educational level, onset duration, and MMSE scores between these 2 groups. Ten age-and gender ratio-matched healthy elderly subjects were used as controls. Emotion Stroop task was performed to these 3 groups： emotion Stroop task images were presented with colored positive or negative emotion words （ such as HAPPY or SUICIDE, etc. ） at the left part of the image to induce emotional responses and with pure color at the right part of the image. The subjects were asked to press the right button when the ink color of the emotion word was congruent with the color at the right part, and press the left button when the ink color of the word was not congruent with the color at the right part. Neutral words were used in the test of general word task. The reaction time, false ratio, and missing ratio were recorded. Functional MRI （fMRI） was conducted. The behavioral data were analyzed with SPSS 11.0 software and the fMRI data were analyzed with SPM2 software. Results The emotion Stroop task showed that the reaction time of the normal control group was 848 ms ± 320 ms, significantly shorter than those of the dAD and AD groups （ 1528 ms± 302 ms and 1173 ms ± 237 ms respectively, both P 〈 0. 01） , and the reaction time of the AD group was significantly shorter than that of the dAD group too （P =0.04）. The false ratio of the normal control group was 0.5%, significantly lower than those of the AD and dAD groups （7.6% and 9.7% respectively, both P 〈0.01 ）, and there was not a signifi

关 键 词：阿尔茨海默病 抑郁症 磁共振成像 情绪 

分 类 号：R749.16[医药卫生—神经病学与精神病学]