首发抑郁症患者重复经颅磁刺激术治疗前后局部脑血流灌注对比研究  

Changes of the regional cerebral blood flow in first-onset depressive disorder patients before and after the treatment of repetitive transcranial magnetic stimulation

作　　者：杜萍[1,2] 折霞[1] 刘康[1] 席一斌[1] 印弘[1] 宦怡[1] 杨晓斌[1] 

机构地区：[1]第四军医大学西京医院放射科,陕西西安710032 [2]解放军第四五一医院放射科

出　　处：《实用放射学杂志》2014年第2期195-198,共4页Journal of Practical Radiology

基　　金：国家重点基础研究发展计划（973计划）项目（2011CB707805）.

摘　　要：目的 探讨首发抑郁症患者重复经颅磁刺激术治疗前后局部脑血流灌注的变化.方法 采用非侵入性脉冲式动脉自旋标记（PASL）技术与SPM5软件、PVE-lab软件[1]研究首发抑郁症患者重复经颅磁刺激术（rTMS）治疗前后局部脑血流灌注（rCBF）的变化.研究对象包括16例首发抑郁症患者,16例健康对照者.结果 治疗前,首发抑郁症患者与正常对照组相比,右侧枕中回、枕下回及尾状核rCBF明显增加;左额叶中上回、中回眶部及左侧小脑、左侧脑岛及右侧岛盖rCBF明显减低.经4周有效治疗后,左额叶、脑岛rCBF较治疗前明显恢复.结论 本研究结果表明,rTMS治疗有效的首发抑郁症患者rCBF变化是可逆的,还表明脉冲式动脉自旋标记作为一种非侵入性磁共振成像技术,可以用于评价rTMS的疗效.Objective To detect the changes of the regional cerebral blood flow（rCBF） in first-onset depressive disorder patients before and after the treatment of repetitive transcranial magnetic stimulation（rTMS）.Methods Using a non invasive technique of pulsed arterial spin labelling （PASL） and SPM5 software,PVE-lab software to measure regional cerebral blood flow （rCBF） changes in first-onset depressive disorder patients before and after the treatment of rTMS.Sixteen first-onset depressive disorder patients and sixteen healthy controls were entered into the study.Results Before the treatment,compared with the healthy controls,patients with first-onset depressive disorder had increased rCBF in the right middle occipital gyrus,inferior occipital gyrus and the caudate nucleus;had decreased rCBF in the left superior-middle frontal gyrus,orbital of middle frontal gyrus,left cerebellum,left insula and right pars opercularis.After four-weeks effective treatment,the patients had significantly recovered rCBF in the left frontal lobe and left insula.Conclusion The study indicated that changes of the rCBF could be reversible in the patients receive effective rTMS treatment.Also demonstrated that as a non-invasive magnetic resonance imaging technique,PASL can be used to evaluate the efficacy of rTMS.

关 键 词：首发抑郁症 重复经颅磁刺激术 磁共振成像 局部脑血流灌注 脉冲式动脉自旋标记技术成像 

分 类 号：R749.4[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]