首发男性双相障碍I型躁狂发作患者额叶白质和海马氢质子波谱研究  

A proton magnetic resonance spectroscopy imaging study on prefrontal lobe and hippocampus in male pa- tients with first-episode mania

作　　者：崔立谦[1] 蒋莉君[1] 邓伟[1] 黄朝华[1] 陈壮飞[1] 李名立[1] 王强[1] 王英成[1] 马小红[1] 龚启勇[2] 李涛[1] 

机构地区：[1]四川大学华西医院精神医学研究室,成都610041 [2]四川大学华西医院临床磁共振研究中心,成都610041

出　　处：《中华行为医学与脑科学杂志》2012年第4期330-332,共3页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：基金项目：国家自然科学基金重点项目（30530300）,“973”课题项目（2007CB12301）

摘　　要：目的探讨双相I型躁狂患者额叶白质、海马的磁共振质子波谱（’H—MRS）变化特点。方法对符合美国精神障碍诊断与统计手册第4版（DSM-IV）诊断标准的18例男性双相I型躁狂发作患者和27名正常对照进行氢质子波谱扫描，检测双侧额叶白质和海马的N-乙酰天门冬氨酸（NAA）、胆碱（Cho）和肌酸（Cr），以Cr为参照物，分别计算双侧NAA／Cr、Cho／Cr比值。结果双相I型躁狂组左侧额叶白质、左侧海马NAA／Cr比正常对照组降低[（1．68±0．19，1．86±0．19），（1．32±0．10，1．43±0．16）]，差异有统计学意义（t=2．99，2．62，P〈0．01），右侧额叶白质、海马NAA／Cr和双侧额叶白质、海马Cho／Cr与正常对照相比差异无统计学意义（t=0．29—1．59，P〉0．05）。结论男性双相I型躁狂患者存在左侧额叶白质纤维和海马神经元的功能障碍。Objective To identify the metabolic alterations on prefrontal lobes and hippocampus in male patients with the first-episode mania using proton magnetic resonance spectroscopy（ 1 H-MRS）. Method 18 male patients with the first-episode mania and 27 healthy subjects matched for age, gender, and years of education were included in the study. 1 H-MRS was performed in two sides of the hippoeampus and frontal lobes regions. The ratios of N-acetylaspartate （NAA） , choline （Cho）to creatine （Cr） were measured . One-sample t test and paired-samples t test were used for statistic process. Results Male patients with the first-episode mania presented decreased NAA/Cr in left frontal lobe and hippocampus regions when compared to normal controls（ left frontal lobe（ 1.68 ± 0.19 vs 1.86 ± 0.19 ）, hippoeampus （ 1.32 ±0. 10 vs 1.43 ±0.16 ）, P 〈 0.01 ）, but there were no significant difference in NAA/Cr for right fi＇ontal lobe and hippocampus regions between groups （ all P 〉 0.05 ）. Two groups also showed no significant difference for Cho/Cr in bilateral frontal lobe and hippocampus （P 〉 0. 05 ）. Conclusion There is significant difference of manifestation of 1H-MRS between male patients with mania and normal controls,which reflects ncuronal dysfunction in the prefrontal lobes and hippocampus.

关 键 词：双相障碍 额叶 海马 磁共振波谱学 

分 类 号：R749.16[医药卫生—神经病学与精神病学]