静息态功能磁共振研究未治疗首次发作重症抑郁症患者默认网络功能连接  

A resting-state fMRI study of default-mode network connectivity in first-episode, treatment-naive major depressive disorder

作　　者：郁仁强[1] 张志伟[1] 吕发金[1] 高玉军[2] 彭刚[1] 杜莲[3] 刘欢[3] YU Renqiang;ZHANG Zhiwei;LV Fajin;GAO Yujun;PENG Gang;DU Lian;LIU Huan(Department of Radiology , The First Affiliated Hospital , Chongqing Medical University , Chongqing 400016, China;Department oj Psych iatry. Tian you Hospital Affiliated to Wuhan University of Science and Technology ,Wuhan 430064, China;Department of Psych iatry , The First A j filiated Hospital, Chongqing Medical Uni-jersity Chongqing 400016, China)

机构地区：[1]重庆医科大学附属第一医院放射科,重庆400016 [2]武汉科技大学附属天佑医院精神科,湖北武汉430064 [3]重庆医科大学附属第一医院精神科,重庆400016

出　　处：《西部医学》2019年第4期608-613,共6页Medical Journal of West China

基　　金：重庆医科大学院级培育基金(PYJJ2017-30)

摘　　要：目的探讨静息态功能磁共振(rs-fMRI)技术和种子点功能连接的方法对未治疗首次发作重症抑郁症(MDD)患者默认网络(DMN)的功能连接改变。方法选取2016年6月～2018年1月重庆医科大学附属第一医院收治的16例MDD患者为观察组,并同时选取19例年龄、性别和受教育年限相匹配的健康志愿者为照组,均行rs-fMRI扫描,运用基于种子点的功能连接方法,提取脑DMN相关脑区,选择功能连接显著差异脑区(P<0.01)作为感兴趣区(ROI),并行ROI脑区功能连接强度与其汉密尔顿抑郁量表评分及发作时间做直线相关分析。结果观察组DMN相关的脑区分布于双侧楔前叶、左侧内侧和旁扣带回、右侧内侧额上回、左侧背外侧额上回、右侧额中回、右侧颞上回;而对照组DMN相关的脑区分布于双侧楔前叶、右侧角回、双侧额中回、双侧颞中回;与对照组相比,观察组DMN在左内侧额上回脑区功能连接强度值显著减低(P<0.01)。观察组左内侧额上回功能连接强度值与其汉密尔顿抑郁量表评分(r=-0.084,P=0.756)、发作持续时间(r=-0.116,P=0.670)不相关。结论未治疗首次发作重症抑郁症患者存在默认网络功能连接异常,但未发现其与患者抑郁严重程度和发作持续时间有相关性。Objective The purpose of this study was to investigate functional connectivity (FC) changes in the default mode network (DMN) in untreated patients with first episode of major depressive disorder (MDD) by using resting-state function magnetic resonance imaging (rs-fMRI) and the seedbased analysis method. Methods 16 MDD patients and 19 healthy controls with matched age, sex and education were included and underwent rs-fMRI. Functional connectivity was conducted between the time courses of the posterior cingulate cortex and each voxel. Significantly changed (P<0.01) brain region which was related to DMN network was selected as region of interest (ROI). Further linear correlation analysis was performed between the functional connectivity coefficient and Hamilton depression scale score. Results The brain regions of DMN in the MDD patients distributed in bilateral precuneus, left medial and parietal cingulate gyrus, right medial frontal gyrus, right medial frontal gyrus and right superior temporal gyrus. The brain regions of DMN in healthy controls distributed in bilateral precuneus, right angular gyrus, bilateral medial frontal gyrus, and bilateral middle temporal gyrus. Compared with healthy controls, the DMN connection strength of left medial frontal gyrus was significantly decreased in the MDD patients (P<0.01). There was no correlation with difference between the connection strength of left medial frontal in the MDD patients and the Hamilton Depression Scale (r=0.084, P=0.756), the duration of MDD (r=0.116, P=0.670). Conclusion There is abnormal function of DMN in untreated patients with first episode of MDD, but it is not found to be related to the severity of depression and the duration of seizures.

关 键 词：未治疗首次发作 重症抑郁症 默认网络 静息态 功能磁共振 

分 类 号：R445.2[医药卫生—影像医学与核医学] R741[医药卫生—诊断学]