伴混合特征抑郁症和双相情感障碍患者脑局部一致性和功能连接模式分析  

Analysis of regional homogeneity and functional connectivity among the depression and bipolar disorder with mixed features patients

作　　者：刘悦 刘瑞 关霖 刘歆怡 周晶晶[2] 黄凯音 鲁顺利 于爱红 Liu Yue;Liu Rui;Guan Lin;Liu Xinyi;Zhou Jingjing;Huang Kaiyin;Lu Shunli;Yu Aihong(Department of Radiology,Beijing Anding Hospital,Capital Medical University,Beijing 100088,China;Beijing Key Laboratory of Mental Disorders,National Clinical Research Center for Mental Disorders&National Center for Mental Disorders,Beijing Anding Hospital,Capital Medical University,Advanced Innovation Center for Human Brain Protection,Capital Medical University,Beijing 100088,China)

机构地区：[1]首都医科大学附属北京安定医院放射科,北京100088 [2]首都医科大学附属北京安定医院、国家精神疾病医学中心、国家精神心理疾病临床医学研究中心、精神疾病诊断与治疗、北京市重点实验室、人脑保护高精尖创新中心、首都医科大学,北京100088

出　　处：《中华放射学杂志》2023年第7期741-747,共7页Chinese Journal of Radiology

基　　金：国家自然科学基金(81901368,U19B2032);北京市属医院科研培育计划(PX2020072,PX2020074)。

摘　　要：目的探讨不伴有混合特征抑郁症(MDD_(noMF))、伴混合特征抑郁症(MMF)、伴混合特征双相情感障碍(BMF)、不伴有混合特征双相情感障碍(BDnoMF)患者脑区的局部一致性(ReHo)特征,寻找伴混合特征抑郁症和双相情感障碍的脑功能活动和脑功能连接的神经影像学模式。方法该研究为横断面研究。收集2021年4月至2022年6月就诊于首都医科大学附属北京安定医院门诊的MDD_(noMF)患者(MDD_(noMF)组)、BDnoMF患者(BDnoMF组)、MMF患者(MMF组)、BMF患者(BMF组)及性别和年龄相匹配健康对照者(HC组)。采集所有受试者的静息态功能像和结构像脑影像数据,应用基于MATLAB的DPABI软件获得受试者全脑的局部一致性(ReHo)值,先采用协方差分析进行总体比较,然后采用LSD或Games-Howell事后检验方法进行组间比较;再以差异脑区为种子点,计算其与去全脑的功能连接结果。结果共纳入MDD_(noMF)组29例、MMF组24例、BMF组26例、BDnoMF组29例、HC组42名。5组左侧梭状回和左侧楔前叶脑区ReHo值的差异有统计学意义(P<0.05),其中MMF组、BMF组和BDnoMF组患者左侧梭状回ReHo值较HC组降低,MDD_(noMF)组、MMF组、BMF组、BDnoMF组左侧楔前叶的ReHo值较HC组升高(P<0.05);MMF组左侧梭状回ReHo值较MDD_(noMF)组降低(P=0.001);BMF组左侧梭状回ReHo值较MDD_(noMF)、BDnoMF组降低(P<0.05)。5组左侧梭状回与小脑蚓部、左侧脑岛、右侧壳核和左侧内侧额上回的功能连接差异有统计学意义,左侧的楔前叶与右侧背外侧额上回功能连接差异有统计学意义(P<0.05)。其中MDD_(noMF)、MMF和BDnoMF组左侧梭状回与小脑蚓部的功能连接较HC组升高,MDD_(noMF)、MMF、BMF、BDnoMF组左侧梭状回与左侧脑岛、左侧内侧额上回和右侧壳核的功能连接较HC组升高(P<0.05);MMF、BMF和BDnoMF组左侧梭状回与左侧脑岛的功能连接较MDD_(noMF)组升高(P<0.05),BMF、BDnoMF组左侧梭状回与左侧内侧额上回的功能连接较Objective To investigate the regional homogeneity(ReHo)among the major depressive disorder patients without mixed features(MDD_(noMF)),major depressive disorder with mixed features(MMF),bipolar disorder with mixed features(BMF)and bipolar disorder patients without mixed features(BDnoMF)patients,and to explore the brain activity and functional connectivity patterns of the MMF and BMF patients.Methods This was a cross-sectional study.The MDD_(noMF)patients(MDD_(noMF)group),MMF patients(MMF group),BMF patients(BMF group),BDnoMF patients(BDnoMF group),and age-and gender-matched healthy controls(HC group)were recruited from Beijing Anding Hospital,Capital Medical University between April,2021 and June,2022.All the participants underwent resting-state functional MRI scanning.The ReHo values was computed with the DPABI software based on the MATLAB.Firstly,the difference in ReHo among the patients with MDD_(noMF),MMF,BMF,BDnoMF and HC group were estimated by the analysis of covariance and the post-hoc method(LSD or Games-Howell).And then,the brain regions with significant different ReHo values were selected as the seeds to calculate the functional connectivity with the whole brain.Results A total of 29 cases in the MDD_(noMF)group,24 cases in the MMF group,26 cases in the BMF group,29 cases in the BDnoMF group,and 42 in the HC group were included.The differences in ReHo values in the left fusiform and the left precuneus of the 5 groups were statistically significant(P<0.05).Among of them,the ReHo values of the left fusiform were lower in the MMF,BMF and BDnoMF groups compared with the HC group(P<0.05),while the ReHo values of the left precuneus in MDD_(noMF),MMF,BMF and BDnoMF groups were higher than that in the HC group(P<0.05).The ReHo value of the left fusiform was lower in the MMF group compared with the MDD_(noMF)group(P=0.001);the ReHo value of the left fusiform was lower in the BMF group compared with the MDD_(noMF)and BDnoMF groups(P<0.05).The functional connectivity between the left fusiform and vermis,left insu

关 键 词：抑郁症 双相情感障碍 磁共振成像 混合特征 局部一致性 功能连接 

分 类 号：R749.4[医药卫生—神经病学与精神病学]