有非自杀性自伤行为首发儿童青少年抑郁障碍患者的大脑自发神经活动特点  

Study of spontaneous neural activities in first-episode of childhood and adolescent depressive disorder with non-suicidal self-injury

作　　者：辛博[1] 王朝敏[1] 李娜[1] 余明[1] 刘艳菊[1] 郭新字[1] 王蒙 刘前莉 刘虹 刘春梅[1] Xin Bo;Wang Chaomin;Li Na;Yu Ming;Liu Yanju;Guo Xinzi;Wang Meng;Liu Qianli;Liu Hong;Liu Chunmei(Department of Mental Health,the First Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第一医院精神卫生科,石家庄050000

出　　处：《神经疾病与精神卫生》2022年第1期13-17,F0003,共6页Journal of Neuroscience and Mental Health

基　　金：河北省卫健委医学科学研究课题(20201154)。

摘　　要：目的探讨有非自杀性自伤(non-suicidal self-injury,NSSI)行为的首发儿童青少年抑郁障碍患者静息状态下的大脑自发神经活动特点。方法选择2021年2—6月就诊于河北医科大学第一医院精神卫生中心符合美国精神障碍诊断与统计手册第5版(DSM-5)中抑郁障碍诊断标准的50例首发儿童青少年抑郁障碍患者(患者组),根据DSM-5评估有无NSSI行为,将患者分为有NSSI组(n=27)和无NSSI组(n=23),同期招募50名健康志愿者作为对照组。采用24项汉密尔顿抑郁量表(HAMD24)评估患者的抑郁症状,采用低频振幅(ALFF)分析探讨有NSSI行为的首发儿童青少年抑郁障碍患者静息状态下的大脑局部自发神经活动特点。结果有NSSI组、无NSSI组和对照组的ALFF值在左侧眶额回、右侧楔前叶、左侧颞上回、左侧丘脑、右侧尾状核和右侧海马差异有统计学意义(F=-4.54、-4.79、-4.48、5.35、4.49、5.39,P<0.05,GRF校正);相较于无NSSI组,有NSSI组ALFF值增高的脑区为左侧丘脑和右侧尾状核,降低的脑区为右侧楔前叶(t=4.84、4.76、-6.02,P<0.05,GRF校正)。结论有NSSI行为的首发儿童青少年抑郁障碍患者静息状态下存在情绪调节和自我认知相关脑区(如左侧丘脑、右侧尾状核和楔前叶)的局部自发神经活动异常。Objective To explore the characteristics of spontaneous neural activities at resting in firstepisode of childhood and adolescent depressive disorder with non-suicidal self-injury(NSSI).Methods A total of 50 first-episode children and adolescents with depressive disorder,who met the diagnostic criteria of depressive disorder in the fifth edition of American Diagnostic and Statistical Manual of mental disorders(DSM-5)in the mental health center of the First Hospital of Hebei Medical University from February to June 2021 were selected as patient group.According to DSM-5,the patients were evaluated for NSSI behavior and divided into two groups:NSSI group(n=27)and non-NSSI group(n=23).At the same time,50 healthy volunteers were recruited as the control group.All enrolled patients were evaluated with the 24-item Hamilton Depression Scale(HAMD24)for depressive symptoms.Low frequency amplitude(ALFF)analysis was used to investigate the characteristics of local spontaneous neural activities at resting in first-episode of childhood and adolescent depressive disorder with NSSI.Results There were statistically significant differences of ALFF values in the left orbitofrontal gyrus,right precuneus,left superior temporal gyrus,left thalamus,right caudate nucleus and right hippocampus in the NSSI group,non-NSSI group and control group(F=-4.54,-4.79,-4.48,5.35,4.49,5.39;P<0.05,GRF correction).Compared with those in non-NSSI group,the left thalamus and right caudate nucleus showed higher ALFF values,and the right precuneus showed lower ALFF values in NSSI group(t=4.84,4.76,-6.02;P<0.05,GRF correction).Conclusions The local spontaneous neural activity of emotional regulation and self-perception related brain regions(such as left thalamus,right caudate nucleus and precuneus)were abnormal at resting-state in first-episode of childhood and adolescent depressive disorder with NSSI.

关 键 词：抑郁障碍 儿童青少年 非自杀性自伤 低频振幅 

分 类 号：R749.4[医药卫生—神经病学与精神病学]