静息态下抑郁症患者脑功能与临床症状的相关性  

Relationship between Regional Homogeneity and Separate Symptom Clusters of Depression:a Resting-state fMRI Study.

作　　者：姚志剑[1,2] 王丽[1] 卢青[3] 刘海燕[1] 滕皋军[2] 

机构地区：[1]南京医科大学脑科医院精神科,南京210029 [2]东南大学中大医院放射科,南京210009 [3]东南大学学习科学研究中心,南京210096

出　　处：《中国心理卫生杂志》2009年第9期680-684,共5页Chinese Mental Health Journal

基　　金：国家高技术研究发展计划(863计划)(2008AA02Z410);国家自然科学基金(30500179);江苏省自然科学基金(BK2005427);南京市医学重点科技发展项目(ZKX05003);儿童发展与学习科学教育部重点实验室开放课题(CDLS-2009-07)

摘　　要：目的:探讨静息态下抑郁症患者脑局部一致性(regional homogeneity,ReHo)与抑郁症状群的关联。方法:17名首发重性抑郁症患者与17名性别、年龄、教育程度相匹配的健康者参与了静息态功能磁共振(fMRI)的扫描。将患者的脑ReHo值与其抑郁症状群进行相关分析,设P<0.005,k值≥10为相关具有统计学意义。结果:抑郁症患者以下症状群与脑区的相关具有统计学意义。焦虑与右前额中部、左脑岛ReHo值呈负相关(r=-0.85,-0.55;均P<0.001);认知障碍与左前额中部、右脑岛ReHo值负相关(r=-0.83,-0.67;P<0.01),而与右海马旁回ReHo值正相关(r=0.90;P<0.01);迟缓与左前额中部、右额下回、右尾状核ReHo值负相关(r=-0.66,-0.67,-0.55;均P<0.001),而与右前扣带回腹侧ReHo值呈正相关(r=0.80,P<0.001);睡眠障碍与左楔前叶、右脑岛ReHo值负相关(r=-0.72,-0.66;P<0.01);绝望感与左后扣带回ReHo值负相关(r=-0.84,P<0.001)。结论:本研究提示抑郁症患者的焦虑、认知障碍、迟缓、睡眠障碍及绝望感症状可能是部分特定的脑神经异常活动的表现。Objective： To examine the relationship between regional homogeneity （ReHo） and separate symptom clusters of depression. Methods： Seventeen first-episode major depressed patients and 17 gender, age, and education matched normal controls experienced resting-state fMRI scans. Correlation analysis was performed in the ReHo value of depressed patients and symptom clusters, P 〈0. 005 and k value≥10 were used to determine the significance. Results： In depressed patients, anxiety was negatively correlated with the ReHo in right middle prefrontal cortex and left insula （ r = - 0. 85, - 0. 55 ; Ps 〈 0. 01 ） . Cognitive disturbance was negatively correlated with the ReHo in left middle prefrontal cortex and right insula （ r = - 0. 83, - 0. 67, Ps 〈 0. 01 ）, and positively correlated with the ReHo in right parahippocampal gyrus （ r =0. 90, P 〈0. 01 ） . Retardation was negatively correlated with the ReHo in left middle prefrontal cortex, right inferior frontal gyrus and right caudate （ r = - 0.66, - 0. 67 and - 0.55, Ps 〈 0. 01 ）, and positively correlated with the ReHo in right ventral anterior cingulate （ r = 0. 80, P 〈0. 01 ） . Sleep disturbance was negatively correlated with the ReHo in left precuneus and right insula （ r = - 0. 72, - 0. 66 ; Ps 〈 0. 01 ） . Hopelessness was negatively correlated with the ReHo in right posterior cingulate （r = -0. 84, P 〈 0. 01） . Confusion： The findings indicate that separate depressive symptom clusters such as anxiety, cognitive disturbance, retardation, sleep disturbance and hopelessness are associated with specific brain activity patterns.

关 键 词：抑郁症 磁共振成像 汉密尔顿抑郁量表 静息态 局部一致性 病例对照研究 

分 类 号：R749.41[医药卫生—神经病学与精神病学] R816.1[医药卫生—临床医学]