首发抑郁症患者治疗前后悲伤体验的fMRI研究  

Responses with Sad Emotional Processing in First-onset Major Depressive Disorder by Antidepressant Treatment Investigated with Functional MRI

作　　者：孙军[1,3] 刘含秋[1] 孙华平[1] 张俊海[1] 冯晓源[1] 郭琴[2] 施慎逊[2] 

机构地区：[1]复旦大学附属华山医院放射科,上海200040 [2]复旦大学附属华山医院精神科 [3]南京医科大学附属南京第一医院放射科

出　　处：《中国医学计算机成像杂志》2009年第6期500-506,共7页Chinese Computed Medical Imaging

基　　金：上海市科委(064119535);上海市功能磁共振成像重点实验室开放课题基金(FMRI061201)~~

摘　　要：目的:应用功能磁共振成像技术,探讨首发抑郁症患者治疗前后体验悲伤表情的脑功能区变化特点。方法:采用3.0T磁共振机,对13例首发抑郁症患者(分别于抗抑郁药物治疗前及治疗8周后)和14例性别、年龄相匹配的正常志愿者进行fMRI检查。运用SPM2分析软件,比较悲伤表情(与中性表情对照)体验的脑功能区变化。结果:悲伤体验时,治疗前患者组扣带回前部皮质活动性较正常人增高(P<0.001,uncorrected),治疗后明显恢复(P<0.001,uncorrected)。结论:悲伤体验的fMRI是一项用来动态评价抑郁症患者情感障碍的重要手段,可以作为一项客观评价抗抑郁药物疗效的重要生物学指标。Purpose： To detect changes of response toward sad facial expressions in first- onset major depressive disorder（MDD） by antidepressant treatment investigated with functional magnetic resonance imaging （fMRI） . Methods： Thirteen patients with first onset MDD and 14 normal age - matched volunteers underwent fMRI, and patients underwent scanning twice during an 8 - week period. Blood oxygenation level dependent （BOLD） images were processed using SPM2 to compare of function in whole brain between the two groups during exposure to neutral, positive and negative pictures. Results： Increased activation of anterior cingulate cortex （ACC） during exposure to sad pictures were found in patients compared with control groups（P 〈 0. 001, uncorrected） . Symptomatic improvement after antidepressant was associated with reversion of ACC （P 〈 0. 001, uncorrected） . Conclusion： Changes in response associated with symptomatic improvement indicate that fMRI may be a useful surrogate marker of antidepressant treatment response.

关 键 词：抑郁症 药物治疗 功能磁共振成像 悲伤表情 

分 类 号：R445.2[医药卫生—影像医学与核医学] R749.4[医药卫生—诊断学]