首发抑郁症患者脑纹状体多巴胺D2受体结合力与脑功能局部一致性改变的多模态影像研究  

Multi-modal imaging study of striatal dopamine 92 receptors binding potential and brain regional homogeneity in patients with first-episode major depressive disorder

作　　者：张继良 孙萌萌 轩昂 付畅 尤阳 徐俊玲 Zhang Jiliang;Sun Mengmeng;Xuan Ang;Fu Chang;You Yang;Xu Junling(Department of Radiology,People＇s Hospital of Zhengzhou University,Henan Provincial People＇s Hospital,Zhengzhou 450003,Chin)

机构地区：[1]郑州大学人民医院河南省人民医院放射科,450003 [2]郑州大学人民医院河南省人民医院PET-CT中心,450003

出　　处：《中华放射学杂志》2018年第7期495-501,共7页Chinese Journal of Radiology

基　　金：河南省医学科技攻关计划省部共建项目（201701026）

摘　　要：目的探讨静息状态下首发抑郁症患者脑多巴胺D2受体结合力（BPND）和脑功能局部一致性（ReHo）改变以及二者之间的关系。 方法2014年12月至2015年12月前瞻性收集首发抑郁症患者及人口学特征与其相匹配的健康志愿者接受静息状态下脑11C-雷氯必利（11C-Raclopride）PET-CT和fMRI多模态扫描。应用基于MATLAB的MIAKAT软件及Rest1.8软件计算受试者全脑多巴胺D2受体BPND及ReHo值，采用Rest1.8软件及SPSS 20.0软件进行配对样本t检验、两独立样本t检验及Pearson相关分析探讨抑郁症患者脑多巴胺D2受体BPND及ReHo值改变以及两种改变之间的相关性。 结果20例首发抑郁症患者纳入抑郁症组，20名健康志愿者纳入对照组，两组均为右利手，在年龄（t=1.33，P=0.19）、性别（χ2=0.10，P=0.75）方面差异均无统计学意义。与对照组相比，抑郁症组双侧纹状体（尾状核、壳核）、双侧内侧前额叶及右侧丘脑ReHo值增高（体素数27~56，P〈0.05），左侧额中回、左侧前扣带回、左侧海马及右侧杏仁核ReHo值减低（体素数21~35，P〈0.05）。与对照组相比，抑郁症组双侧尾状核及双侧壳核D2受体BPND减低（t=－4.41~－3.13，P〈0.05）。抑郁症组左、右两侧尾状核及壳核的D2受体BPND与其ReHo值间均为负相关（r=－0.81~－0.62，P〈0.05）；左、右两侧尾状核及壳核的D2受体BPND与其同侧内侧前额叶的ReHo值间均为负相关（r=－0.86~－0.52，P〈0.05）；左、右两侧尾状核及壳核的D2受体BPND与左侧额中回、右侧丘脑、左侧前扣带回、左侧海马及右侧杏仁核的ReHo值间无相关性（r=－0.27~0.39，P〉0.05）。 结论首发抑郁症患者存在脑纹状体区多巴胺递质水平异常及多巴胺奖赏环路相关脑区神经元活动性异常，且两种异常间具有一定相关性。ObjectiveTo explore the correlation between changes of striatal dopamine D2 receptors non-displaceable binding potential （BPND） in 11C-Raclopride PET-CT and brain regional homogeneity （ReHo） derived from resting state functional MRI （fMRI） in patients with first-episode major depressive disorder （MDD）. MethodsPatients with first-episode MDD and age and sex matched healthy volunteers accepted brain 11C-Raclopride PET-CT and resting state fMRI. MIAKAT based on MATLAB and Rest 1.8 were used to calculate BPND of brain dopamine D2 receptors and brain ReHo, respectively. Changes of striatal dopamine D2 receptors BPND and brain ReHo values were analyzed by paired-sample t test and two independent sample t-test, and Pearson correlation analysis was used to analyze the correlation between BPND and ReHo. ResultsTwenty patients with first-episode MDD were enrolled as MDD group, and 20 healthy volunteers as the control group. The two groups were all right-handed, and there were no statistical differences for age （t=1.33, P=0.19） and gender （χ2=0.10, P=0.75）. Compared with the control group, the ReHo in MDD patients increased in the bilateral striatum （caudate nucleus and putamen）, bilateral medial prefrontal lobes, and right thalamic （27 to 56 voxels, P〈0.05） and decreased in the left middle frontal gyrus, the left anterior cingulate, the left hippocampal and the right amygdala （21 to 35 voxels, P〈0.05）. In addition, compared with the control group, BPND of bilateral caudate nucleus and putamen dopamine D2 receptors in the MDD group were decreased （t=-4.41 to-3.13, P〈0.05）. Furthermore, there was a negative correlation between D2 receptors BPND and ReHo of bilateral caudate nucleus and putamen （r=-0.81 to-0.62, P〈0.05）. And there was a negative correlation between ReHo of the bilateral medial prefrontal lobes and BPND of the same lateral caudate nucleus and putamen D2 receptors in the MDD group （r=-0.86 to-0.52, P〈0.05）. Besides, ReHo of the left middle frontal

关 键 词：抑郁症 磁共振成像 正电子发射断层显像术 体层摄影术 X线计算机 

分 类 号：R749.4[医药卫生—神经病学与精神病学] R816.1[医药卫生—临床医学]