轻中度抑郁障碍认知功能损伤治疗前后脑局部一致性研究  

Regional homogeneity study on cognitive impairment in patients with mild to moderate depressive disorder with Fluoxetine treatment

作　　者：郭萌 姚冠群 李曜均 高盼月 李忻蓉 刘莎[2,3] 徐勇 GUO Meng;YAO Guanqun;LI Yaojun;GAO Panyue;LI Xinrong;LIU Sha;XU Yong(First Hospital of Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学第一临床医学院,太原030001 [2]精神障碍人工智能辅助诊疗山西省重点实验室 [3]山西医科大学第一医院精神卫生科

出　　处：《中国神经精神疾病杂志》2021年第5期273-277,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：国家自然科学基金(编号:81971601,81701326);山西省科技成果转化引导专项(编号:201904D131020);山西省教育厅高校科技创新计划项目(编号:2020L0203);认知障碍多学科诊疗山西省科技创新团队(编号:201705D13102)。

摘　　要：目的采用局部一致性(regional homogeneity,ReHo)方法探索药物干预轻中度抑郁障碍患者认知功能损伤的神经影像学机制.方法纳入14例轻中度抑郁患者以及19名健康对照,患者使用氟西汀治疗8周,在基线以及8周进行汉密尔顿抑郁量表(Hamilton depression scale,HAMD)、汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)评估以及韦氏智力测验、韦氏记忆测验,患者组在基线、治疗8周和对照组在基线进行静息态功能磁共振检查,计算ReHo值.结果患者组经过8周治疗后HAMD、HAMA、总智商、操作智商、言语智商、记忆商数均有改善,差异均有统计学意义(P<0.01).基线时,患者组双侧小脑ReHo值高于对照组(P<0.05),而双侧尾状核、右侧顶下缘角回ReHo值低于对照组(P<0.05);患者组经过8周治疗后与基线相比,右侧小脑ReHo值降低(P<0.05),而右侧顶下缘角回ReHo值升高(P<0.05).患者组在治疗8周时右侧顶下缘角回ReHo值与韦氏总智商(r=0.68,P=0.01)、操作智商(r=0.58,P=0.03)、言语智商(r=0.62,P=0.02)、记忆商数(r=0.63,P=0.02)评分呈正相关.结论轻中度抑郁障碍患者小脑、尾状核及顶下缘角回脑区神经活动存在异常,经治疗后认知功能有所恢复,同时与认知功能相关的小脑、顶下缘角回脑区神经活动有所恢复,这些脑区功能改变可能在轻中度抑郁障碍的发展过程起重要作用.Objective To explore the neuroimaging mechanism of drug intervention on cognitive impairment in patients with mild to moderate depression using regional homogeneity(ReHo)method.Methods The Hamilton Depression Scale(HAMD),Hamilton Anxiety Scale(HAMA)assessment,Wechsler's Intelligence Test and Wechsler's Memory Test were performed on 14 patients with mild to moderate depression and 19 healthy controls at baseline and 8 weeks.The patients were treated with fluoxetine for 8 weeks.The patient group underwent resting state functional magnetic resonance imaging at baseline,8 weeks and the control group at baseline.The ReHo values were calculated.Results The HAMD,HAMA,total IQ,operational IQ,speech IQ and memory quotient of the patient group improved after 8 weeks of treatment,and the difference was significant(P<0.01).At baseline,the bilateral cerebellar ReHo value of the patient group was higher than that of the control group(P<0.05),while the bilateral caudate nucleus and the right inferior parietal gyrus ReHo values were lower than those of the control group(P<0.05).After 8 weeks of treatment,the ReHo value of the right cerebellum of the patient group decreased(P<0.05),while the ReHo value of the right inferior parietal gyrus increased(P<0.05).There was a positive correlation between the Wechsler's total IQ(r=0.68,P=0.01),operational IQ(r=0.58,P=0.03),verbal IQ(r=0.62,P=0.02),and memory quotient(r=0.63,P=0.02)scores in the patient group after 8 weeks of treatment.Conclusion In patients with mild to moderate depression,the cerebellum,the caudate nucleus,and the inferior parietal gyrus exhibit abnormal nerve activity.In addition,cognitive function and its associated cerebellum and inferior parietal gyrus have recovered after treatment.Functional changes in these brain areas may play an important role in the development of mild to moderate depression.

关 键 词：抑郁障碍 局部一致性 认知功能 

分 类 号：R749.4[医药卫生—神经病学与精神病学]