青少年抑郁症的执行功能损害与脑结构磁共振研究  

Study on executive function impairment and structural MRI in adolescents with depression

作　　者：刘小玉[1] 王学义[1] 任庆云[2] 金圭星[1] 刘春梅[1] 尤红[1] 王金成[1] 史少霞[1] 郭新字[1] 王永良[1] 

机构地区：[1]河北医科大学第一医院精神卫生科,河北石家庄050031 [2]河北医科大学第一医院放射科,河北石家庄050031

出　　处：《临床荟萃》2012年第15期1296-1298,F0002,共4页Clinical Focus

基　　金：河北省科学技术研究与发展计划项目(09276103D-10)

摘　　要：目的探讨青少年抑郁症患者的执行功能损害以及结构性磁共振的变化。方法收集符合美国精神障碍诊断与统计手册第4版(DSM-Ⅳ)抑郁症诊断标准的40例抑郁症患者(研究组),20例正常对照(对照组)。采用威斯康星卡片分类测验系统和Stroop色词测验评定执行功能,以磁共振静态三维结构进行影像学检查。结果青少年抑郁症患者执行功能评分治疗前后均低于正常对照组,完成分类数(3.35±1.98)个vs(4.55±1.70)个;错误应答数(52.15±18.83)个vs(37.75±21.27)个;持续性应答(33.75±17.49)个vs(26.55±20.10)个;持续性错误数(28.30±13.43)个vs(27.35±5.91)个;卡片A反应时间(55.28±7.46)秒vs(53.23±6.24)秒;卡片B反应时间(85.78±7.45)秒vs(80.78±8.12)秒;卡片C反应时间(117.32±9.58)秒vs(111.67±8.95)秒;Stroop干扰效应(50.33±12.14)秒vs(46.78±11.54)秒(P<0.05)。治疗后,完成分类数、持续性错误数和卡片C反应时间与治疗前差异仍有统计学意义(P<0.05)。青少年抑郁症患者的额叶灰质体积明显小于正常对照(P<0.05)。结论青少年抑郁症患者的执行功能损害可能是一个持续存在的独立症状,额叶脑结构异常与其存在密切关系。Objective To investigate the executive impairments and characterize MRI changes in adolescents with depression. Methods Forty depressed adolescent patients and twenty health adolescent controls were assessed for executive function using the Wisconsin Card Sorting Test（WCST）,the Stroop Color Word Test（SCW）. MRI static 3D structures were used to evaluate the patients. Results Before and after the treatment,the study group performed poorer on all of executive function tests than control group,Category Completed （3.35 ± 1.98） pieces vs （4.55 ± 1.70） pieces; response errors （ 52. 15 ± 18.83） pieces vs （37.75 ± 21.27 ） pieces; response perseverative （ 33. 75 ± 17.49 ） pieces vs （29. 60 ±15.06） pieces; perseverative errors score （28.30±13.43） pieces vs （24.15± 12.25） pieces;reaction time A （55.28±7.46） s vs （53.23±6.24） s;reaction ime B（85.78±7.45） s vs （80.78±8.12） s;reaction time C （117.32± 9.58） s vs （111.67±8.95） s;Stroop interference effects （50.33±12.14） s vs （46.78±11.54） s（ P 〈0.05）. There were remarkable differences on CC,Re and RTC （ P 〈0.05） before and after the treatment. The gray matter volume of some brain areas including the frontal lobes were lower in depression than in the normal control group（ P 〈0.05）. Conclusion The impairment of executive function in young patients with depression is observed in the period of disease,which could improve after treatment, the reason is related with the lower gray matter volume of the frontal lobes.

关 键 词：抑郁症 青少年 认知障碍 磁共振成像 

分 类 号：R749.42[医药卫生—神经病学与精神病学]