抑郁症患者纹状体功能连接异常的静息态fMRI研究  

Abnormal striatum functional connectivity in major depressive disorder:a resting state functional magnetic resonance imaging study

作　　者：陈枫 陈观茂 龚佳英 贾艳滨[2] 钟舒明[2] 齐张璋 赖顺凯 黄力[1] 王颖[1] Chen Feng;Chen Guanmao;Gong Jiaying;Jia Yanbin;Zhong Shuming;Qi Zhangzhang;Lai Shunkai;Huang Li;Wang Ying(Medical Imaging Center,First Affiliated Hospital of Jinan University,Guangzhou 510630,China;Department of Psychiatry,First Affiliated Hospital of Jinan University,Guangzhou 510630,China)

机构地区：[1]暨南大学附属第一医院医学影像中心,广州510630 [2]暨南大学附属第一医院精神心理科,广州510630

出　　处：《中华精神科杂志》2019年第3期193-199,共7页Chinese Journal of Psychiatry

基　　金：国家自然科学基金(面上项目81671670,81501456,81471650);广东省社会发展领域科技计划项目(2014B020212022);广州市科技计划项目(20160402007,201604020184).

摘　　要：目的探讨抑郁症患者纹状体功能连接(functional connectivity,FC)的特征。方法选取50例未服药的抑郁症患者(抑郁症组)和48名健康对照者(对照组)进行静息态功能磁共振(resting-state functional magnetic resonance imaging,rs-fMRI)扫描,对rs-fMRI数据进行常规预处理,基于纹状体分区为双侧下腹侧纹状体、双侧上腹侧纹状体、双侧背侧尾状核、双侧背侧壳核尾、双侧背侧壳核头及双侧腹侧壳核头,以上述12个种子点进行全脑功能连接分析,采用双样本t检验比较2组间脑功能连接的差异,经不依赖阈值集群增强(threshold-free cluster enhancement,TFCE)的多重比较校正,并将差异有统计学意义脑区的FC值与24项汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD24)评分等临床变量进行Pearson相关分析。结果与对照组相比,抑郁症组左侧背侧壳核尾与右侧颞上回(t=-5.46,P<0.008,TFCE校正)FC值减低,右侧背侧壳核头与双侧中央后回(右侧t=-4.85,左侧t=-4.81)及左侧楔前叶(t=-4.58)FC值减低(均P<0.008,TFCE校正)。上述脑区的FC值与HMAD24评分无相关性(r=0.171、0.002、0.005、0.098,均P>0.05)。结论抑郁症患者纹状体与颞上回、中央后回及楔前叶功能连接异常,上述脑区主要位于感觉运动区域,提示其在抑郁症的病理机制中可能发挥重要作用。Objective To investigate the characteristics of striatum functional connectivity (FC) in patients with major depressive disorder (MDD). Methods Fifty unmedicated patients with MDD and 48 healthy controls underwent resting-state functional magnetic resonance imaging (rs-fMRI) scan. Routine preprocessing of rs-fMRI data was performed. The striatum was divided into bilateral inferior ventral striatum,bilateral superior ventral striatum,bilateral dorsal caudate,bilateral dorsal caudal putamen,bilateral dorsal rostral putamen, and bilateral ventral rostral putamen. Whole brain functional connectivity analysis was performed with the above 12 seed points. And significant differences of each seed FC among two groups were calculated with Two-sample t-test and multiple comparison correction of threshold-free cluster enhancement (TFCE). Finally, correlation analysis was performed between the FC of the brain regions and clinical features (i.e. Hamilton Depression Scale of 24 items (HAMD24) scores). Results In comparison to the control group,the MDD patients showed significantly decreased FC in the left dorsal caudal putamen and the right superior temporal gyrus (t=-5.46, P<0.008, TFCE correction), the right dorsal rostral putamen and bilateral postcentral gyrus (right t=-4.85, left t=-4.81, P<0.008, TFCE correction) and left precuneus (t=-4.58, P<0.008,TFCE correction). There were no significant correlations between the FC values in these regions and HAMD24 scores (r=0.171, 0.002, 0.005, 0.098;all P<0.05). Conclusion The MDD patients possibly have abnormal FC in the striatum and the superior temporal gyrus, the postcentral gyrus and the precuneus, and it suggests these sensorimoter areas may play an important role in the pathological mechanisms of MDD.

关 键 词：抑郁症 磁共振成像 纹状体 功能连接 

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]