抑郁症患者短时记忆损害的脑额叶-边缘叶局部功能研究  

Research on impairment of short-term memory and regional spontaneous neuronal activity in frontal-limbic lobe in patients with major depressive disorder

作　　者：王旭苗 阎锐[1,2] 陈志璐 赵帅 黄映红 花玲玲[1] 汤浩[1] 王晓芹 夏逸 姚志剑[1,2] WANG Xu-miao;YAN Rui;CHEN Zhi-lu;ZHAO Shuai;HUANG Ying-hong;HUA Ling-ling;TANG Hao;WANG Xiao-qin;XIA Yi;YAO Zhi-jian(The Affiliated Brain Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学附属脑科医院,210029 [2]南京大学医学院

出　　处：《临床精神医学杂志》2022年第3期172-176,共5页Journal of Clinical Psychiatry

基　　金：国家自然科学基金(81871066);江苏省重点研发计划专项(BE2018609,BE2019675);江苏省科教强卫工程省市共建医学创新团队(CXTDC2016004);江苏省医学科研重点项目(K2019011);江苏省科教强卫青年医学人才项目(QNRC2016050)。

摘　　要：目的:探究抑郁症患者急性发作期静息态下全脑低频振幅(ALFF)、短时记忆损害特征及两者相关性。方法:招募52例抑郁症患者(抑郁症组)和60名性别、年龄及受教育年限均匹配的健康志愿者(对照组),进行3.0 T静息态功能磁共振扫描,并使用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、韦氏记忆量表(WMS)对被试进行评估。比较两组间ALFF值,并将所得差异脑区ALFF值与抑郁症组临床评估及WMS短时记忆各项得分进行Pearson相关分析。结果:抑郁症组情绪功能受损,短时记忆表现下降。较对照组相比,抑郁症组右额中回眶部(MNI:x=24,y=63,z=-12;K=39),左后扣带回(MNI:x=-12,y=-48,z=30;K=38)的ALFF值差异有统计学意义(体素水平P<0.001,团块水平P<0.05,GRF矫正)。抑郁症组右额中回眶部激活增强,且与再认记忆得分呈负相关(r=-0.302,P=0.029);左后扣带回激活减弱,与HAMA得分呈负相关(r=-0.333,P=0.016),与倒背工作记忆得分呈正相关(r=0.291,P=0.036)。结论:抑郁症患者情绪、短时记忆损害严重,与右额中回眶部和左后扣带回等脑区功能异常有关。Objective:To investigate the characteristics of amplitude of low frequency fluctuations(ALFF)in resting state and impairment of short-term memory and their correlation in acute depressive episodes patients.Method:52 patients diagnosed with depression were recruited(depression group),along with 60 healthy controls(control group)matched for gender,age and years of education.They were asked to complete 3.0 T MRI scanning and evaluated with Hamilton Depression Scale(HAMD-17),Hamilton Anxiety Scale(HAMA)and Wechsler Memory Scale(WMS).ALFF were compared between the two groups,among which the correlation analysis between different brain activity and the score of HAMD,HAMA,WMS in patients were performed by Pearson correlation analysis.Results:The depression group showed worse performance in short-term memory tests tested by WMS.Compared to the control group,there were significant differences of ALFF values in right orbital middle frontal gyrus(R-MFG)(MNI:x=24,y=63,z=-12;K=39)and left posterior cingulate cortex(L-PCC)(MNI:x=-12,y=-48,z=30;K=38)(voxel size P<0.001,cluster size P<0.05,GRF corrected).The depression group showed significantly increased in R-MFG,which was negatively correlated with the score of recognition memory(r=-0.302,P=0.029).Compared with the control group,the ALFF of depression group showed decreased in L-PCC,which was negatively correlated with the score of HAMA(r=-0.333,P=0.016)and positively correlated with the score of the backward digit span item(r=0.291,P=0.036).Conclusion:Depressed patients have significant impairment in short-term memory functions and abnormal activity in short-term memory relevant brain regions such as the R-MFG and the L-PCC.

关 键 词：抑郁症 短时记忆 功能磁共振 低频振幅 工作记忆 

分 类 号：R749.3[医药卫生—神经病学与精神病学]