青年抑郁症患者额叶三维氢质子波谱和扩散张量成像研究  

Detection of frontal biochemical abnormalities in youth with major depression using three-dimensional hydrogen proton MR spectroscopy and diffusion tensor imaging

作　　者：李建军[1] 孔祥泉[1] 林明方[2] 王桂华[3] 蒋湘玲[2] 李传资[3] 余宁[3] 赵应满[3] 郭敏[2] 

机构地区：[1]华中科技大学同济医学院附属协和医院放射科,湖北武汉430022 [2]海南省人民医院心理咨询与治疗中心 [3]海南省人民医院放射科,海南海口570311

出　　处：《中国医学影像技术》2007年第5期659-662,共4页Chinese Journal of Medical Imaging Technology

基　　金：海南省卫生厅科研基金资助(琼卫2005-73号)

摘　　要：目的应用MR三维氢质子波谱(3D1H MRS)和扩散张量成像(DTI)技术,探讨青年抑郁症患者额叶可能存在的神经生化异常。方法对54例青年抑郁症患者(抑郁症组)和50例年龄和性别匹配的志愿者(正常对照组)进行3D1H MRS和DTI研究,测量双侧额叶背外侧白质和前部扣带回皮质的N-乙酰天门冬氨酸(NAA)、胆碱复合物(Cho)、肌醇(mI)和肌酸(Cr)的绝对值,计算NAA、Cho、mI与Cr的比值,以及双侧额叶白质的表观弥散系数(ADC)和各向异性分数(FA),并对两组进行对比分析。结果①抑郁症组患者前额叶扣带回皮质Cho、mI的绝对值及Cho/Cr、mI/Cr比值明显高于对照组,P<0.01;而NAA绝对值、NAA/Cr比值两组间差异无统计学意义,P>0.05。②抑郁症组前额叶背外侧白质内NAA、Cho、mI的绝对值以及与Cr的比值与对照组比较,均无统计学意义,P值均>0.05。③抑郁症组患者前额叶白质的ADC值明显高于对照组,FA值明显低于对照组P值均<0.01)。结论前额叶扣带回皮质的Cho、mI值及Cho/Cr、mI/Cr比值增高、以及前额叶白质的ADC值增高和FA值降低可能构成了青年抑郁症患者发病的神经生物学基础。Objective To determine whether the major depression had neuro-biochemical abnormalities in the frontal lobe by using three-dimensional 1^H proton spectroscopy （3D 1^H MRS） and diffusion tensor imaging （DTI）. Methods Fifty-four patients with major depression （MD） and fifty normal age-marched controls （NC） were involved. MRI and 3D 1^H MRS brain scans were performed on all participants. In the bilaterally dorsolateral white matter and cingulate gray matter of the frontal lobe,the absolute levels of N-acetylaspartate （ NAA）, choline （Cho）, myo-inositol （mI） and creatine （Cr） were measured, and their ratios of metabolite to Cr levels were computed from the absolute values. The value of apparent diffusion coefficients （ADC） and fractional antisotropys （FA） were measured in the white matter of frontal lobe. Results The absolute values of Cho and mI, Cho/Cr and mI/Cr ratios in cingulate gyrus gray were significant higher in youth MD patients than those in NC （P〈0.05）, but no significant difference was detected in the absolute value of NAA and NAA/Cr ratio in cingulate gyrus gray between the two groups （P〉0.05）. There were no significant differences in the levels of NAA, Cho, mI, and NAA/Cr, Cho/Cr, mI/Cr ratios in dorsolateral white matter of the frontal lobe between both groups （P〉0.05）. The value of ADC in white matter of frontal lobe was significant higher in youth MD patients than those in NC （P〈0.01）, but the value of FA in white matter of frontal lobe was significant lower in youth MD patients than those in NC （P〈0.01）. Conclusion The higher leverls of Cho, mI, and Cho/Cr, mI/Cr ratios in cingulate gyrus gray. The higher value of ADC and lower value of FA in white matter of frontal lobe may provide some of the neurobiological substrates to youth MD.

关 键 词：抑郁症 磁共振波谱 扩散张量成像 额叶 

分 类 号：R749.4[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]