伴与不伴焦虑抑郁情绪的原发性失眠磁共振弥散张量成像研究  

Diffusion tensor imaging study of primary insomnia with or without anxiety and depression

作　　者：张晓琦[1] 孙玮[1] 魏红霞 翟冬枝[1] ZHANG Xiaoqi;SUN Wei;WEI Hongxia(The Second Affiliated Hospital of Zhengzhou University, Zhengzhou 450014, China)

机构地区：[1]郑州大学第二附属医院,河南郑州450014

出　　处：《精神医学杂志》2022年第1期35-38,共4页Journal of Psychiatry

基　　金：河南省科技攻关计划项目(编号:182102310473)。

摘　　要：目的利用磁共振弥散张量成像(DTI)技术探讨伴或不伴焦虑、抑郁情绪的原发性失眠(PI)患者的脑白质微观变化。方法选取50例PI患者和25名健康志愿者(健康对照组),根据汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)评分将PI患者分为伴焦虑抑郁组和不伴焦虑抑郁组各25例,三组均进行常规MRI和DTI扫描,测定DTI图像上多个部位脑白质区的平均弥散系数(ADC)与各向异性分数(FA)均值,并分析组间差异性。结果与健康对照组比较,伴焦虑抑郁PI组与PI组患者的左侧前额叶皮层,双侧顶叶、前扣带回、海马区域、杏仁核FA值减低、ADC值升高(P<0.05)。相关性分析发现,伴焦虑抑郁PI组双侧前额叶皮层、顶叶皮层、前扣带回、海马及杏仁核区域FA值与HAMA、HAMD评分均呈负相关(P<0.05)。结论DTI研究发现PI患者脑白质的微观结构存在异常,焦虑抑郁情绪对PI的影响较深,定量反映神经纤维束微细变化,对PI的临床诊断及病理生理机制提供基础。Objective To explore the microscopic changes of white matter in primary insomnia(PI)patients with or without anxiety and depression through diffusion tensor imaging(DTI).Methods A total of 50 patients with PI who were divided into PI with anxiety and depression group(25 cases)and PI without anxiety and depression group(25 cases)according to their total scores of Hamilton Anxiety Scale(HAMA)and Hamilton Depression Scale(HAMD)and 25 healthy volunteers in control group were selected and underwent routine MRI scan and DTI.The mean values of average diffusion coefficient(ADC)and fractional anisotropy(FA)of white matter in DTI images were measured,and the differences among groups were analyzed.Results FA values of left prefrontal cortex,bilateral parietal cortex,anterior cingulate cortex,hippocampal,amygdala in PI with and without anxiety and depression groups were lower than those in control group,and ADC values were higher than those in control group(P<0.05).Correlation analysis showed that FA values of bilateral prefrontal cortex,parietal cortex,anterior cingulate cortex,hippocampal,amygdala in PI with anxiety and depression group were significantly negatively correlated with the total scores of HAMA and HAMD(P<0.05).Conclusion It is found through DTI that the microscopic changes of white matter in PI patients are abnormal,and anxiety and depression have a deep influence on PI,which reflect the microchanges of nerve fiber bundles quantitatively,providing a basis for clinical diagnosis and pathophysiological mechanism of PI patients.

关 键 词：原发性失眠 焦虑 抑郁 弥散张量成像 各向异性分数 平均弥散系数 

分 类 号：R749.99[医药卫生—神经病学与精神病学]