伴焦虑强迫症状的抑郁症患者前额叶血红蛋白浓度变化的近红外光图谱分析  

Analyzing prefrontal cortex hemoglobin concentration exchange spectrum in patients with major depressive disorder combined with anxiety and obsession through near-infrared spectroscopy

作　　者：刘晓敏[1] 张小芊[1] 徐波[1] 申晨煜 史璐洁 马湘雲 任夏瑾 孙高翔[1] 冯坤[1] 朱焱[1] 刘破资[1] 

机构地区：[1]清华大学玉泉医院精神卫生科,北京100049

出　　处：《中华精神科杂志》2014年第3期158-163,共6页Chinese Journal of Psychiatry

基　　金：国家自然科学基金（81061120532）

摘　　要：目的应用近红外光谱成像技术（functional near—infrared spectroscopy，fNIRS）研究综合医院精神科有焦虑和强迫症状的抑郁症患者前额叶功能激活的特点。方法采用fNIRS测量比较30例抑郁症患者（患者组）和30名对照（对照组）在执行语义言语流畅任务（verbal fluency task，VFT）时前额叶血红蛋白浓度变化，利用HAMD、HAMA、耶鲁-布朗强迫量表（Y—BOCS）、症状自评量表（SCl-90）进行心理评估，并采用Spearman相关进行相关性分析。结果（1）与对照组比较，患者组前额叶外侧通道和中间下侧通道含氧血红蛋白任务期升高幅度的差异有统计学意义（均P〈0．05）；（2）患者组焦虑症状与右外侧前额叶激活程度相关（r=0．370、0．380，均P〈0．05），抑郁症状与左右外侧前额叶及中间背侧前额叶激活程度相关（r=0．391、0．375、0．403、0．492、0．396、0．362、0．384，均P〈0．05），强迫症状与前额叶激活程度无统计学相关性。结论具有焦虑和强迫症状的抑郁症患者存在前额叶功能激活下降，且焦虑症状和抑郁症状可能分别与右外侧前额叶、~＇I-N前额叶及中间背侧前额叶激活程度相关。Objective Exploring the characteristics of prefrontal cortex activation in patients of major depressive disorder （MDD） combined with anxiety and obsession through functional near-infrared spectroscopy （fNIRS）. Methods Prefrontal cortex hemoglobin concentration exchange of 30 MDD patients combined with anxiety and obsession was detected by fNIRS under voice fluency task （VFT）, then psychological assessment was made using Hanmilton Depression Scale （ HAMD ）, Hamilton Anxiety Scale （HAMA） and Symptom Checklist 90 （SCL-90）. The exchange and assessment scores were compared. Results （ 1 ） Compared with control group, the decreased Oxy-Hb exchange was confirmed in lateral and lower prefrontal cortex in MDD patients （P 〈 0. 05 ） ;（2） Oxy-Hb exchange in right-lateral prefrontal cortex were associated with the severity of anxiety （ r = 0. 370,0. 380, both P 〈 0. 05 ） , while that in bilateral prefrontal cortex and antero-medial prefrontal cortex were associated with severity of depression（ r = 0. 391, 0. 375,0. 403,0. 492,0. 396,0. 362,0. 384, all P 〈 0. 05 ）. And no statistical correlation was observed between severity of obsession and prefrontal cortex. Conclusion It indicated hypoactivation state of prefrontal cortex was in MDD patients, while the severity of anxiety and depression may be associated with right-lateral prefrontal cortex, bilateral and antero-medial prefrontal cortex.

关 键 词：谱学 近红外线 前额叶皮质 言语流畅任务 情绪 抑郁症 焦虑 强迫 观念行为 

分 类 号：R749.4[医药卫生—神经病学与精神病学]