轻中度抑郁症静息态fMRI低频振幅与血清炎症因子相关性研究  

Correlation between low-frequency amplitude and serum inflammatory factors in resting-state functional magnetic resonance imaging in mild to moderate depression

作　　者：马跃 何家恺 郭春蕾 孙继飞 鲁新宇 罗屹 高山山 陈庆燕 张樟进[4] 荣培晶[2] 方继良[1] 刘勇 MA Yue;HE Jiakai;GUO Chunlei;SUN Jifei;LU Xinyu;LUO Yi;GAO Shanshan;CHEN Qingyan;ZHANG Zhangjin;RONG Peijing;FANG Jiliang;LIU Yong(Department of Radiology,Guang'anmen Hospital,China Academy of Traditional Chinese Medicine,Beijing 100053,China;Institute of Acupuncture and Moxibustion,China Academy of Traditional Chinese Medicine,Beijing 100700,China;Department of Radiology,Affiliated Hospital of Traditional Chinese Medicine,Southwest Medical University,Luzhou 646099,China;School of Chinese Medicine,the University of Hong Kong,Hong Kong 999077,China)

机构地区：[1]中国中医科学院广安门医院放射科,北京100053 [2]中国中医科学院针灸研究所,北京100700 [3]西南医科大学附属中医医院放射科,泸州646099 [4]香港大学中医药学院,中国香港999077

出　　处：《磁共振成像》2023年第9期1-6,18,共7页Chinese Journal of Magnetic Resonance Imaging

基　　金：国家自然科学基金(编号:82174282、81774433);中国中医科学院科技创新工程项目(编号:CI2021A03301)。

摘　　要：目的探索轻中度抑郁症(mild to moderate depression,MMD)的脑功能低频振幅(amplitude of low-frequency fluctuation,ALFF)与血清炎症因子的相关性。材料与方法回顾性分析2020年1月至2021年10月在中国中医科学院广安门医院和西南医科大学附属中医医院精神科被诊断为MDD的患者病例作为MMD组。健康者来源于广告招募,作为健康对照(healthy controls,HC)组。最终共纳入48例MMD患者病例及51例HC,且两组满足性别、年龄及受教育程度相对匹配。受试者均参加功能MRI(functional MRI,fMRI)静息态脑功能扫描,测定血清肿瘤坏死因子α(tumor necrosis factor alpha,TNF-α)、白介素6(interleukin 6,IL-6)、白介素2(interleukin 2,IL-2)、高敏C反应蛋白(high-sensitivity C-reactive protein,HsCRP)和17项汉密尔顿抑郁量表(17-items Hamilton Depression Rating Scale,HAMD-17)、14项汉密尔顿焦虑量表(14-items Hamilton Anxiety Rating Scale,HAMA-14)评分。采用DPABI软件对fMRI数据进行预处理与统计分析,获得两组差异脑区ALFF值,采用Spearman秩相关分别对ALFF值与临床量表及炎症因子值进行相关性分析。结果MMD组在HAMD-17、HAMA-14评分上显著高于健康组(P<0.05),IL-2、IL-6、TNF-α、HsCRP水平升高。与健康组相比,MMD组的ALFF值在左侧颞下回增高,右侧颞极、左侧三角部额下回、右侧背外侧额上回减低。相关分析显示:左侧颞下回与HAMD-17、HAMA-14评分、HsCRP水平呈正相关(r=0.591,P<0.001;r=0.549,P<0.001;r=0.479,P<0.001);右侧背外侧额上回与TNF-α呈负相关(r=-0.285,P=0.004),HsCRP水平与HAMD-17、HAMA-14评分呈正相关(r=0.723,P<0.001;r=0.667,P<0.001)。结论MMD患者存在免疫炎症因子异常,MMD组存在ALFF差异脑区,主要位于边缘叶、默认网络等脑网络,其中左侧颞下回、右侧背外侧额上回是外周炎症因子相关的异常脑区,这可能是MMD神经免疫病理机制更为复杂的原因。Objective:To explore the correlation between the brain functional amplitude of low-frequency fluctuation(ALFF)and serum inflammatory factors in mild to moderate depression(MMD).Materials and Methods:A total of 48 MMD patients and 51 healthy controls were included.All participants underwent functional MRI(fMRI)resting-state brain functional scans,and the levels of serum tumor necrosis factor alpha(TNF-α),interleukin 6(IL-6),interleukin 2(IL-2),and high-sensitivity C-reactive protein(HsCRP)were measured.The 17-item Hamilton Depression Rating Scale(HAMD-17)and 14-item Hamilton Anxiety Rating Scale(HAMA-14)were used to assess the participants'clinical symptoms.The DPABI software was used for preprocessing and statistical analysis of fMRI data to obtain the ALFF values of different brain regions between the two groups.Spearman rank correlation analysis was conducted to explore the relationships between ALFF values,clinical scales,and inflammatory factor levels.Results:The MMD group had significantly higher scores on HAMD-17 and HAMA-14 compared to the healthy control group(P<0.05).The levels of IL-2,IL-6,TNF-αand HsCRP were elevated in the MMD group.Compared to the healthy control group,the MMD group showed increased ALFF values in the left temporal subregion and decreased values in the right temporal pole,left triangular part of the inferior frontal gyrus,and right dorsolateral prefrontal cortex.The correlation analysis revealed a positive correlation between the left temporal subregion and HAMD-17,HAMA-14,and HsCRP(r=0.591,P<0.001;r=0.549,P<0.001;r=0.479,P<0.001),a negative correlation between the right dorsolateral prefrontal cortex and TNF-α(r=-0.285,P=0.004),and a positive correlation between HsCRP and HAMD-17,HAMA-14(r=0.723,P<0.001;r=0.667,P<0.001).Conclusions:MMD patients exhibit abnormal immune-inflammatory factors,and there are ALFF differences in specific brain regions,mainly involving the limbic and default mode networks.The left temporal subregion and right dorsolateral prefrontal cortex are abnormal b

关 键 词：轻中度抑郁症 静息态功能磁共振成像 磁共振成像 低频振幅 血清炎症因子 

分 类 号：R445.2[医药卫生—影像医学与核医学] R749.4[医药卫生—诊断学]