伴自杀意念重性抑郁障碍患者的弥散张量成像  

Diffusion Tensor Imaging in Patients with Major Depressive Disorder with Suicidal Ideation

作　　者：张然[1] 汤艳清[1] 魏胜男[2] 王菲[1,2] ZHANG Ran;TANG Yanqing;WEI Shengnan;WANG Fei(Department of Psychiatry,The First Hospital,China Medical University,Shenyang 110001,China;Department of Radiology,The First Hospital,China Medical University,Shenyang 110001,China)

机构地区：[1]中国医科大学附属第一医院精神医学科,沈阳110001 [2]中国医科大学附属第一医院放射科,沈阳110001

出　　处：《中国医科大学学报》2018年第10期871-875,共5页Journal of China Medical University

基　　金：国家自然科学基金(81725005;81701336);辽宁省教育厅科学研究一般项目(L2015591)

摘　　要：目的比较有无自杀意念的重性抑郁障碍(MDD)患者弥散张量成像的异同,寻找伴自杀意念MDD患者脑白质的特异性改变。方法用贝克自杀意念量表和17项汉密尔顿抑郁量表对34例伴自杀意念MDD患者、54例无自杀意念MDD患者和57例健康志愿者进行评估,并采集弥散张量成像数据。结果与健康对照组相比,伴自杀意念MDD组在胼胝体膝部和压部、大脑脚、上纵束、右下纵束、左侧内囊后肢以及左侧丘脑后辐射均有统计学差异,且伴自杀意念MDD组与无自杀意念MDD组间在以上脑区也存在差异,无自杀意念MDD组与健康对照组相比,左侧内囊后肢、胼胝体压部和上纵束未发现统计学差异。结论伴自杀意念MDD患者存在特异性白质损伤,其自杀意念可能与内囊、胼胝体以及上纵束的白质信号异常有关。Objective To identify specific white matter changes in major depressive disorder(MDD)with suicidal ideation using diffusion tensor imaging(DTI)to compare patients with and without suicidal ideation.Methods Using the Beck 19-item Scale for Suicide Ideation and the 17-item Hamilton Depression Rating Scale,34 MDD patients with suicidal ideation,54 MMD patients without suicidal ideation,and 57 healthy controls(HC)were evaluated.All subjects underwent DTI.Results Compared with the HC group,the MDD group with suicidal ideation showed significant differences(P<0.05)in the genu and splenium of the corpus callosum,cerebral peduncle,superior longitudinal fasciculus,right inferior longitudinal fasciculus,left posterior limb of the internal capsule,and left posterior thalamic radiation.Moreover,there were significant differences(P<0.05)in those regions between MDD patients with and without suicidal ideation.However,no significant differences(P>0.05)were observed in the left posterior limb of the internal capsule,splenium of the corpus callosum,and superior longitudinal fasciculus between MDD group without suicidal ideation and HC group.Conclusion MDD patients with suicidal ideation have specific white matter changes,and suicidal ideation may be associated with abnormalities of white matter in the internal capsule,corpus callosum,and superior longitudinal fasciculus.

关 键 词：重性抑郁障碍 自杀意念 弥散张量成像 

分 类 号：R749.4[医药卫生—神经病学与精神病学]