重性抑郁患者电休克治疗前后脑默认网络的静息态功能磁共振研究  

Resting-state Functional Magnetic Resource Imaging of Default-mode Network in Patients with Major Depressive Disorder Before and After Electroconvulsive Therapy

作　　者：史丹丹[1] 陈莉[1,2] 罗天友[1] 马超豪 刘丹[1] 

机构地区：[1]重庆医科大学附属第一医院放射科,重庆400016 [2]川北医学院基础医学院解剖教研室,四川南充637000

出　　处：《中国医学影像学杂志》2016年第10期721-724,728,共5页Chinese Journal of Medical Imaging

基　　金：国家临床重点专科建设项目(国卫办医函[2013]544号)

摘　　要：目的采用静息态功能磁共振(rf MRI)技术研究首发未治疗重性抑郁患者电休克治疗前后脑默认网络的功能连接改变情况,初步探讨电休克治疗重性抑郁症的脑神经机制。资料与方法收集2014年4月-2015年5月在重庆医科大学附属第一医院诊断为重性抑郁症的患者24例,并分别于电休克治疗前后进行rf MRI扫描及24项汉密尔顿抑郁量表(HDRS24)测试。应用独立成分分析法分别筛选出电休克治疗前后静息态默认网络成分,并分析组间差异。分别提取治疗前后默认网络功能连接差异脑区的功能连接强度值,并与前后2次HDRS24评分进行相关性分析。结果重性抑郁患者电休克治疗后HDRS24评分显著低于治疗前,差异有统计学意义(t=13.975,P<0.05);与治疗前相比,治疗后默认网络中左侧角回功能连接增强(P<0.01,clusters>10),左侧颞中回、右侧后扣带回及左侧前额叶内侧功能连接减低(P<0.01,clusters>10);重性抑郁患者电休克治疗前及治疗后默认网络功能连接差异脑区的功能连接强度与前后2次的HDRS24评分均无显著相关(P>0.05)。结论首发未治疗重性抑郁患者经电休克治疗后默认网络功能连接发生部分逆转,推测为电休克治疗重性抑郁症的重要脑神经机制。Purpose To investigate the change of functional connectivity of default mode network（DMN） in first-episode, treatment-naive patients with major depressive disorder（MDD） before and after electroconvulsive therapy（ECT） using resting-state functional magnetic resonance, and to explore the neural mechanism of ECT on MDD. Materials and Methods Twenty-four patients with MDD diagnosed in the psychiatry department of the First Affiliated Hospital of Chongqing Medical University from April 2014 to May 2015 underwent resting-state functional magnetic resonance scan and 24-item Hamilton depression rating scale（HDRS24） before and after ECT therapy. Independent component analysis（ICA） was used to select the DMN component before and after ECT and to evaluate for functional connectivity. The differences were compared, and correlate with HDRS24. Results HDRS24 scores were significantly lower after ECT in patients with MDD（t=13.975, P〉0.05）. Compared with pre-treatment, the post-treatment functional connectivity increased in the left angular gyrus（P〈0.01, clusters〉10）, and decreased in left middle temporal gyrus, right posterior cingulate and left medial prefrontal cortex（P〈0.01, clusters〉10）. There were no significantly correlation between the functional connectivity of DMN and HDRS24 scores before and after ECT（P〉0.05）. Conclusion The functional connectivity of DMN in patients with MDD after ECT was partially reversed, which may be the important mechanism of ECT.

关 键 词：抑郁症 电惊厥疗法 磁共振成像 静息态 脑功能网络 

分 类 号：R445.2[医药卫生—影像医学与核医学] R749.4[医药卫生—诊断学]