围绝经期女性静息状态下丘脑功能连接与性激素和抑郁症状的相关性  

The resting-state functional connectivity of the hypothalamus and its relationships with gonadal steroid hormones and depression symptoms in perimenopausal women

作　　者：王相兰[1] 陶炯[2] 钟智勇[2] 刘莎 韩自力[2] 张晋碚[2] 李凌江[2] 

机构地区：[1]中南大学湘雅二医院精神卫生研究所,长沙410011 [2]中山大学附属第三医院精神科,长沙410011 [3]广州脑科医院放射科

出　　处：《中华医学杂志》2015年第39期3190-3195,共6页National Medical Journal of China

基　　金：国家重点基础研究发展计划（2013CB835100,2009CB918303）;国家自然科学基金（81171286）;广东省科技计划（20108031600309,20088030301056）

摘　　要：目的 探索静息状态围绝经期女性下丘脑的功能连接及其与性激素和抑郁症状的相关性.方法 本研究纳入2012年10月至2013年6月在广州中山大学附属第三医院精神科广告招募的围绝经期女性志愿者66名,以Zung抑郁自评量表（ZSDS）评估其抑郁症状,以化学发光免疫法检测其雌二醇、睾酮、孕酮水平;采集3.0T静息状态功能磁共振成像数据,以下丘脑为种子区,计算基于体素的下丘脑功能连接z值图;经统计参数图（SPM）单样本t检验生成下丘脑功能连接图;用SPM多重回归分析性激素相关的下丘脑功能连接脑区,然后用Pearson相关分析性激素相关脑区平均z值与ZSDS评分的相关性.结果 围绝经期女性下丘脑功能连接脑区主要为外侧额叶下回,内侧前额叶,背外侧前额叶,眶额叶皮质,膝下皮质,前扣带回,后扣带回,楔形回和楔前叶,海马区,角回（FDR校正q＜0.05）.其中,睾酮与右侧角回-下丘脑连接强度正相关,与右侧膝下皮质-下丘脑和双侧内侧额上回-下丘脑连接强度负相关（PAlphasim＜0.05）,同时右侧膝下皮质平均z值与ZSDS总分（r=0.279,P=0.023）、核心症状分（r=0.278,P=0.024）及躯体症状分（r=0.357,P=0.003）正相关.结论 围绝经期女性静息状态下丘脑和抑郁相关网络及默认网络存在广泛功能连接,而血浆雄激素水平对部分脑区与下丘脑的功能连接强度具有调整作用,并可能降低围绝经期女性对抑郁的易感性.Objective This study aimed to investigate the resting-state functional connectivity of the hypothalamus and its relationships with gonadal steroid hormones and depression symptoms in perimenopausal women.Methods Total 66 perimenopausal women voluntarily participated in this study from October 2012 to June 2013.Zung Self-rating Depression Scale （ZSDS） was used to assess depression symptoms.Plasma gonadal steroid hormones including estradiol, testosterone, and progesterone were determined by the chemiluminescence immunoassay.A 3.0 Tesla magnetic resonance imaging （MRI） scanner was utilized to acquire resting-state functional MRI data.The z-value functional connectivity map of each participant was calculated voxel-wisely based on the seed region of the hypothalamus.One sample t test of Statistical Parametric Mapping （SPM） were used to determine the brain areas with statistically significant functional connectivity to the hypothalamus, then multiple regression of SPM was used to calculate the correlated areas with 3 gonadal steroid hormones, respectively.Finally,Pearson correlation was performed to analyze bivariate correlations between mean z-values and ZSDS scores.Results Significant functional connectivity to the hypothalamus were found in brain areas as follows ： the lateral inferior frontal gyrus, medial prefrontal cortex, dorsal lateral prefrontal cortex, orbitofrontal cortex, subgenual cortex, anterior cingulate cortex, posterior cingulate cortex, cuneus and precuneus, hippocampus and parahippocampal gyms, and angular gyrus （False Discovery Rate q 〈 0.05）.Among these areas, the plasma testosterone level was positively related to the functional connectivity strength of the right angular gyrus, and negatively related to the strengths of the right subgenual cortex and bilateral medial superior frontal gyrus to the hypothalamus （PAlphaSim 〈0.05）.Especially, mean z-value in the subgenual cortex was positively related to the ZSDS index score （r =0.279, P =0.023）, and factor scores of th

关 键 词：抑郁障碍 疾病易感性 绝经 神经影像学 衰老 

分 类 号：R749.4[医药卫生—神经病学与精神病学]