基于RS-fMRI的首发未用药青少年重症抑郁症患者脑功能应用  

The application of brain function in adolescent patients with severe depression and initial non-medication based on RS-fMRI

作　　者：王贝宁 胡霖霖 梁爽 WANG Beining;HU Linlin;LIANG Shuang(School of Imaging,Mudanjiang Medical University,Mudanjiang157011,China;Department of Radiological Diagnosis,Daping Hospital,the Third Affiliated Hospital of Third Military Medical University of Chinese P.L.A,Chongqing 400000,China;Department of Radiology,Hongqi Hospital Affiliated to Mudanjiang Medical University,Mudanjiang 157011,China)

机构地区：[1]牡丹江医学院影像学院,黑龙江牡丹江157011 [2]第三军医大学第三附属大坪医院放射诊断科,重庆400000 [3]牡丹江医学院附属红旗医院放射科,黑龙江牡丹江157011

出　　处：《中国现代医生》2021年第10期117-121,125,共6页China Modern Doctor

基　　金：黑龙江省大学生创新创业训练计划项目(202010229034);黑龙江省卫生健康委科研课题(2020-402)。

摘　　要：目的探讨大脑功能连接性静息态功能磁共振应用首发未用药青少年重症抑郁症患者临床疗效。方法选取2018年1月至2020年1月间牡丹江医学院附属红旗医院心理门诊、牡丹江医学院第二附属医院心理门诊和牡丹江精神病医院门诊MDD组60例和同期招募HCs组60例进行全脑静息态功能磁共振成像扫描,采用RS-fMRI技术定量比对患有MDD青少年与HCs组RSFC值之间的组间差异,并将对所有入组参与者进行CDI、HRDS和DOE之间的相关性分析,探求相应感兴趣区的RSFC与青少年MDD罹患之间是否具有相关性。结果MDD组与HCs组除CDI、HRDS外其他资料比较,差异无统计学意义(P>0.05);存在主要差异的脑区为右侧杏仁核包括右侧额上回,HCs组与MDD组相比(t=3.670,P=0.014,体素个数为167),MDD组RSFC值高于HCs组;左背侧前扣带回皮层包括左脑岛(t=4.670,P=0.018,体素个数为331),MDD组RSFC值低于HCs组;两组比较,差异有统计学意义(P<0.05)。结论首发未用药的青少年抑郁症患者认知功能损害更为严重,右侧杏仁核、左侧前扣带回等大脑区域的低连通性与抑郁症相关的情绪调控辐射和记忆区域具有相关性。Objective To investigate the clinical efficacy of resting-state functional magnetic resonance imaging(rs-fMRI)of brain functional connectivity in adolescent patients with severe depression and initial non-medication.Methods Patients admitted to Psychological Clinic of Hongqi Hospital Affiliated to Mudanjiang Medical University,Psychological Clinic of the Second Affiliated Hospital of Mudanjiang Medical University and Outpatient Department of Mudanjiang Psychiatric Hospital from January 2018 to January 2020 were selected and divided into the MDD group(n=60),patients recruited in the same period were selected and divided into the HCs group(n=60),and all of them were scanned in the whole brain with RS-fMRI.RS-fMRI technology was applied to quantitatively compare the differences between the RSFC values of adolescents in the MDD group and the HCs group.The correlation among CDI,HRDS and DOE was analyzed for all participants,and whether there was correlation between RSFC in corresponding areas of interest and adolescent suffering from MDD.Results There was no statistically significant difference in other information except CDI and HRDS between the MDD group and the HCs group.The main regions with major differences were the right amygdala including the right superior frontal gyrus.Compared with the MDD group(t=3.670,P=0.014,voxel number=167),RSFC value in the MDD group was higher than that in the HCs group.The left anterior cingulate gyrus included the left insula(t=4.670,P=0.018,voxel number=331),and the RSFC value in the MDD group was lower than that in the HCs group.The difference between the two groups was statistically significant(P<0.05).Conclusion The impairment of cognitive function is more severe in adolescent patients with depression and initial non-medication.The low connectivity among the right amygdala,left anterior cingulate gyrus and other brain regions is related to the emotion regulation radiation and depression related memory regions.

关 键 词：抑郁症 青少年 RS-fMRI技术 杏仁核 

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]