伴有焦虑症状青少年双相抑郁患者腹内侧前额叶氢质子磁共振波谱研究  

Proton magnetic resonance spectroscopy in the ventromedial prefrontal lobe of adolescents with bipolar depression with anxiety symptoms

作　　者：王丞基 曲源[3] 张丞[2] 唐潇潇 古力巴克然木·阿布拉[2] 佟钙玉[2] 邹韶红[2] WANG Chengji;QU Yuan;ZHANG Cheng;TANG Xiaoxiao;GULIBAKERANMU·Abula;TONG Gaiyu;ZOU Shaohong(Department of Clinical Psychology,People’s Hospital of Xinjiang Uygur Autonomous Region,Department of Radiology,People’s Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830000,China)

机构地区：[1]石河子大学医学院 [2]新疆维吾尔自治区人民医院临床心理科,乌鲁木齐830000 [3]新疆维吾尔自治区人民医院放射影像中心

出　　处：《中国神经精神疾病杂志》2023年第10期604-608,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：新疆维吾尔自治区自然科学基金(编号:2022D01C606);天山创新团队计划(编号:2022D14011)。

摘　　要：目的探讨青少年双相抑郁患者焦虑症状与腹内侧前额叶(ventromedial prefrontal cortex,vmPFC)神经代谢之间的关系。方法对36例青少年双相抑郁患者采用汉密尔顿焦虑量表(14-item Hamilton anxiety rating scale,HAMA)评估并分组,有焦虑症状组20例,无焦虑症状组16例。采用汉密尔顿抑郁量表(24-Hamilton depression scale,HAMD)评估抑郁症状的严重程度,并行氢质子磁共振波谱(1H-magnetic resonance spectroscopy,1H-MRS)扫描以检测vmPFC内N-乙酰天门冬氨酸(N-acetylaspartate,NAA)、肌醇(myo-inositol,mI)、胆碱(choline,Cho)、肌酸(creatine,Cr)水平。结果有焦虑症状组患者的HAMD评分[24.50(24.00,26.75)vs.23.00(22.00,24.00)]、有精神疾病家族史比例(40.0%vs.0)高于无焦虑症状组,差异有统计学意义(P<0.05);有焦虑症状组患者的mI/Cr水平高于无焦虑症状组(0.58±0.12 vs.0.47±0.11),差异有统计学意义(P<0.05)。有焦虑症状组患者的Cho/Cr和HAMD评分呈正相关(r=0.589,P=0.006),mI/Cr和病程呈负相关性(r=-0.481,P=0.032)。结论青少年双相抑郁患者的焦虑症状可能与vmPFC脑区神经代谢物mI水平升高有关。Objective Exploring the relationship between anxiety symptoms and neurometabolism in the ventromedial prefrontal cortex(vmPFC)of adolescents with bipolar depression.Methods Thirty-six adolescent patients with bipolar depression were assessed and grouped by using the 14-item Hamilton anxiety rating scale(HAMA),including 20 patients with anxiety symptoms and 16 patients without anxiety symptoms.The severity of depressive symptoms was assessed using the 24-Hamilton depression scale(HAMD),and 1H-magnetic resonance spectroscopy(1H-MRS)was used.The difference of vmPFC neurometabolism between 2 groups was compared.Results Compared with the group without anxiety symptoms,the HAMD score[24.50(24.00,26.75)vs.23.00(22.00,24.00)]and the proportion of family history(40.0%vs.0)were significantly higher in the group with anxiety symptoms than in the group without anxiety symptoms(P<0.05).The level of mI/Cr was higher in the group with anxiety symptoms than that in the group without anxiety symptoms(0.58±0.12 vs.0.47±0.11),and the difference was significant(P<0.05).Cho/Cr and HAMD scores in patients with anxiety symptoms were positively correlated(r=0.589,P=0.006),and mI/Cr was negatively correlated with disease duration(r=-0.481,P=0.032).Conclusions Anxiety symptoms in adolescent bipolar depression patients may be related to elevated levels of mI,a neurometabolite in the brain region of vmPFC.

关 键 词：青少年 双相障碍 抑郁发作 焦虑症状 质子磁共振波谱 神经代谢 

分 类 号：R749.4[医药卫生—神经病学与精神病学]