额叶α波不对称与艾司西酞普兰治疗抑郁症效果关联研究  

The correlation of frontal alpha asymmetry and the treatment outcome of escitalopram in patients with depression

作　　者：桑文华[1] 高敏 徐保彦[1] 米琨[1] 庞静娟 张彦恒[1] 刘增龙[1] SANG Wenhua;GAO Min;XU Baoyan;MI Kun;PANG Jingjuan;ZHANG Yanheng;LIU Zenglong(Depatment of affective disorder,the Sixth People’Hospital of Hebei Province,Baoding 071000,China)

机构地区：[1]河北省第六人民医院情感障碍科,保定071000 [2]河北大学临床医学院

出　　处：《中国神经精神疾病杂志》2021年第10期598-602,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：河北省政府资助优秀人才项目(编号:361014)。

摘　　要：目的了解低、高额叶α波不对称(frontal alpha asymmetry,FAA)抑郁症患者使用艾司西酞普兰后的疗效差异。方法纳入抑郁症患者72例,给予艾司西酞普兰治疗8周,在治疗前和治疗8周末评估汉密尔顿抑郁量表(Hamilton depression scale,HAMD-17)、汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)、临床总体印象量表(clinical global impression,CGI)和轻躁狂症状自评量表(32-item hypomania checklist,HCL-32)。治疗前后记录脑电数据并分析前额叶(FP1/FP2)、中额叶(F3/F4)和侧额叶(F7/F8)3个部位FAA,分别以治疗前各位置FAA的中位数为界值将患者分为低FAA组(28例)和高FAA组(28例)。结果所有患者FP1/FP2位置、F3/F4位置、F7/F8位置的FAA在治疗前后差异无统计学意义(P>0.05)。治疗8周末,F3/F4位置低FAA组和高FAA组治疗有效人数差异具有统计学意义(17/28 vs.25/28,P=0.029)。F3/F4位置低FAA组和高FAA组治疗前后HAMD差值、HAMA差值、CGI差值的组间差异均有统计学意义(P<0.05)。相关分析显示F3/F4位置FAA与HAMD差值(r=0.479,P<0.001)、HAMA差值(r=0.504,P<0.001)、CGI差值(r=0.450,P<0.001)呈正相关。结论F3/F4位置高FAA组抑郁症患者经艾司西酞普兰治疗后效果比低FAA组好,即左额叶皮质活动相对增强的抑郁症患者使用艾司西酞普兰治疗效果较好。Objective To understand the difference in response to escitalopram in depression patients with low and high Frontal Alpha Asymmetry(FAA).Methods A total of 72 depression patients were selected and treated with escitalopram for 8 weeks.Patients with depression were assessed with Hamilton Depression Scale(HAMD),Hamilton Anxiety Scale(HAMA),Clinical Global Impression Scale(CGI)and 32-item Hypomania Checklist(HCL-32)at baseline and at the 8th week of treatment.Patients with depression were tested for FAA before and after treatment.Patients were divided into low FAA group(28 cases)and high FAA group(28 cases)according to the median FAA before treatment.Results There was no significant difference in FAA of FP1/FP2 channels,F3/F4 channels and F7/F8 channels before and after treatment(P>0.05).After 8 weeks of treatment,there was a significant difference in the number of effective patients between the low and high FAA groups in the F3/F4 channels(17/28 vs.25/28,P=0.029).There was a significant difference in HAMD difference,HAMA difference and CGI difference between the low and high FAA groups in the F3/F4 channels(P<0.05).Correlation analysis showed that F3/F4 channels FAA and HAMD difference(r=0.479,P<0.001),HAMA difference(r=0.504,P<0.001),CGI difference(r=0.450,P<0.001)were positively correlated.Conclusion Escitalopram exhibits better effects on depression patients with high FAA of F3/F4 channels,particularly,on those with increased activity of left frontal cortex.

关 键 词：抑郁症 额叶α波 不对称 疗效 抗抑郁药物 

分 类 号：R749.4[医药卫生—神经病学与精神病学]