脑卒中后抑郁患者大脑灰质密度基于体素的形态测量学研究  

Voxel-based morphometry on grey matter concentration of the brain in patients with post stroke depression

作　　者：吴磊[1] 吴文[1] 郭荣[1] 曹安[1] 杨建明[2] 

机构地区：[1]南方医科大学珠江医院康复医学科,广州510282 [2]南方医科大学珠江医院影像诊断科,广州510282

出　　处：《中华神经医学杂志》2013年第12期1266-1270,共5页Chinese Journal of Neuromedicine

基　　金：广东省自然科学基金（05300463）

摘　　要：目的运用基于体素的形态测量学分析（VBM）方法，探讨脑卒中后抑郁（PSD）患者双侧前额叶、海马及前扣带回灰质密度特征。方法选择自2012年6月至2013年3月南方医科大学珠江医院康复科收住院的10例PSD患者（PSD组1和13例脑卒中后无抑郁患者（non—PSD组）接受3D高分辨率TIWI序列磁共振扫描，利用基于SPM8的DARTEL工具箱对扫描获得的结构图像进行预处理，并将双侧前额叶、海马及前扣带回作为感兴趣区，最后用双样本t检验比较PSD组与non—PSD组患者双侧前额叶、海马及前扣带回灰质密度差异，以P〈0．001（未校正）、相连体素大于200以上的组块视为有差异的脑区．同时采用双变量相关分析方法分析汉密尔顿抑郁量表（HAMD）评分与PSD组中组间差异有统计学意义的组块的灰质密度值的相关性。结果（1）与non．PSD组相比，PSD组患者右侧前额叶（额中回）灰质密度明显下降（BA10；MNI坐标：x=25．5，y=46．5，z=-1．5；相连体素260voxels；t=30．28，P〈0．001未校正），双侧前扣带回灰质密度明显增高（BA32；MNI坐标：x=1．5，y=45，z=6；相连体素495voxels；t=-13．29，t9〈0．001未校正），而双侧海马灰质密度未发现差异有统计学意义（BA30；MNI坐标：x=18，y=-34．5，z=3；相连体素164voxels；t=5．15，P〈O．001未校正）。（2）在PSD组中，HAMD评分与右侧额中回灰质密度值呈显著正相关性（r==0．687，P=-0．000），与双侧前扣带回灰质密度值无显著相关性（r=0．321，P〉0．05）。结论PSD患者同样存在边缘-皮质环路多个脑区灰质结构的异常，右侧额中回灰质密度值对PSD患者抑郁严重程度的判断有一定的临床价值。Objective To study the differences of gray matter density in the prefrontal cortex, anterior cingulate cortex and hippocampus of patients with post stroke depression （PSD） by using voxel-based morphometry （VBM）. Methods Ten patients with PSD and 13 patients without PSD underwent examination of three-dimensional high-resolution T1 weighted MRI, voxel-wise analyses of regional gray matter density in our hospital from June 2012 to March 2013, were conducted VBM analysis using DARTEL based on SPM8. And the bilateral prefrontal cortex, hippocampus and anterior cingulate were selected as regions of interest; two-sample t-test was used to compare the gray matter density differences; the threshold at P 〈0.001 （not being corrected） and threshold extended 200 voxels were used for the significant brain region; and biriate correlation analysis was used to analyze the correlation of Hamilton Depression （HAMD） scale scores with gray matter density differences in the bilateral prefrontal cortex, hippocampus and anterior cingulated of PSD group. Results As compared with the no-PSD patients, the PSD group patients showed significantly lower gray matter density in the right prefrontal cortex （BA10, MNI coordinate： x=25.5, y=46.5, z=-1.5; connected voxels： 260; t=30.28, P〈0.001 without correction）, significantly higher gray matter density in bilateral anterior cingulated （BA32; MNIcoordinate： x=1.5, y=45, z=6; cormectedvoxels： 495; t=-13.29, P〈0.001 without correction）, and no statistical difference of gray matter density in bilateral hippocampus （BA30; MNI coordinate： x=18, y=-34.5, z=3; connected voxels： 164; t=5.15, P〈0.001 without correction）. Significant positive correlation existed between HAMD scores and gray matter density value in right middle frontal gyms in PSD group （r=0.687, P=0.000）. Conclusion Patients with post stroke depression also have gray matter abnormalities in limbic-cortical-striatal-pallidal-thalamic neural circuit; For PSD patients, the gray matter densit

关 键 词：脑卒中后抑郁 基于体素的形态测量学 灰质密度 前额叶 海马 前扣带回 

分 类 号：R445.2[医药卫生—影像医学与核医学]