帕金森病合并抑郁与脑血流灌注的关系及经颅磁刺激的影响  

The Characteristics of Cerebral Blood Flow Perfusion in Parkinson's Disease with Accompanying Depression and the Influence of Transcranial Magnetic Stimulation

作　　者：杨剑文[1] 胡治平[1] 

机构地区：[1]中南大学湘雅二院神经内科,湖南长沙410015

出　　处：《激光生物学报》2013年第5期432-435,共4页Acta Laser Biology Sinica

摘　　要：目的:应用CT灌注成像技术观察帕金森病合并抑郁患者局灶脑血流灌注的特点,进一步探讨抑郁症发生与脑血流的关系。方法:将41例帕金森患者根据是否合并抑郁症分为帕金森病组22例、帕金森病合并抑郁症者为抑郁组19例、其中抑郁组分为经颅磁刺激(rTMS)治疗前组、治疗后组,3组均进行CT局部脑血流灌注显像,半定量分析各脑区血流灌注情况。结果:帕金森合并抑郁症组患者双侧额叶、颞叶和基底节的脑血流量测定(CBF)较帕金森病组显著下降(P<0.05);抑郁组左、右侧脑血流低灌注存在不对称性,左侧额叶、顶叶的CBF较右侧显著下降(P<0.01);rTMS治疗后脑血流灌注较治疗前改善,HAMD评分改善(P<0.05)。结论:帕金森患者存在局灶性脑血流灌注降低,合并抑郁症患者额、顶叶下降更明显,经颅磁刺激治疗后脑血流低灌注改善。Objective：Using CT perfusion imaging to reveal the characteristics of focal cerebral blood flow perfusion in Parkinson＇s disease with depression and to further explore the relationship between the cerebral blood flow （CBF） and the depression occurrence.Methods：Within 41 patients with Parkinson＇s disease,22 cases were patients without depression and 19 with depression.The 19 patients with depression were treated with transcranial magnetic stimulation （rTMS）.All the patients were performed with CT rCBF imaging and the results of brain blood perfusion between Parkinson＇ s disease without depression and with depression （including pre-treatment and post-treatment with rTMS） were compared by semi-quantitative analysis.Results：Compared with those in patients without depression,the CBFs of bilateral frontal lobe,temporal lobe and basal ganglia in patients with depression decreased significantly （P ＜ 0.05）.In the depression patient,asymmetry existed between the left and the right cerebral hypoperfusions,CBFs of the left frontal lobe and the parietal lobe decreasing significantly （P ＜ 0.01） compared with those of the right side.The CBF perfusion was improved after rTMS therapy,with better HAMD scores （P ＜ 0.05）.Conclusion：Patients with Parkinson＇s disease have focal cerebral perfusion reduction.The CBFs of the frontal and the parietal lobes in the patients with depression decreased significantly.The CBF perfusion was improved after rTMS therapy.

关 键 词：帕金森病 抑郁症 局部脑血流灌注 经颅磁刺激 

分 类 号：R742.5[医药卫生—神经病学与精神病学]