青少年双相抑郁患者冲动攻击行为神经代谢改变:一项质子磁共振波谱成像研究  

Neurometabolic changes in impulsive aggressive behavior in adolescent bipolar depression:a proton magnetic resonance spectroscopy study

作　　者：王丞基 曲源[3] 沈小琴 唐潇潇 佟钙玉[2] 陈鹏莉[2] 邹韶红[2] Wang Chengji;Qu Yuan;Shen Xiaoqin;Tang Xiaoxiao;Tong Gaiyu;Chen Pengli;Zou Shaohong(School of Medicine,Shihezi University,Shihezi 832000,China;Department of Clinical Psychology,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830000,China;Radiology Center,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830000,China)

机构地区：[1]石河子大学医学院,832000 [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,乌鲁木齐830000

出　　处：《神经疾病与精神卫生》2024年第1期37-41,共5页Journal of Neuroscience and Mental Health

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

摘　　要：目的基于质子磁共振波谱成像(1H-MRS)技术分析青少年双相抑郁(ABD)患者冲动攻击行为(IAB)与腹内侧前额叶(vmPFC)神经代谢的关系。方法回顾性选取2023年1—7月新疆维吾尔自治区人民医院临床心理科门诊及住院部收治的23例30 d内未经任何治疗的ABD患者为研究对象。将Barratt冲动量表(BIS-11)总分≥70分、外显攻击行为量表(MOAS)加权总分≥5分且体力攻击条目得分≥1分的患者纳入伴IAB组,将BIS-11总分<70分、MOAS加权总分<5分且体力攻击条目得分为0分的患者纳入不伴IAB组。采用1H-MRS单体素扫描vmPFC,比较两组患者vmPFC脑区N-乙酰天门冬氨酸/肌酸(NAA/Cr)、胆碱/肌酸(Cho/Cr)、肌醇/肌酸(mI/Cr)的比值。结果伴IAB组有11例患者,不伴IAB组有12例患者。伴IAB组ABD患者的NAA/Cr值为(1.45±0.16),低于不伴IAB组的(1.69±0.08),差异有统计学意义(t=4.548,P<0.001)。两组患者的Cho/Cr值、mI/Cr值比较[(0.64±0.10)比(0.66±0.08)、(0.49±0.19)比(0.54±0.08)],差异均无统计学意义(t=0.530、0.751;均P>0.05)。结论ABD伴IAB患者的NAA/Cr值下降,ABD患者的IAB可能与vmPFC神经元密度减少或存在神经元功能障碍有关。Objective To analyze the relationship between impulsive aggressive behavior(IAB)and ventromedial prefrontal cortex(vmPFC)neurometabolism in adolescent bipolar depression(ABD)using proton magnetic resonance spectroscopy(1H-MRS)technology.Methods From January to July 2023,23 ABD patients admitted to the Outpatient and Inpatient Departments of Clinical Psychology of People's Hospital of Xinjiang Uygur Autonomous Region without any treatment within 30 days were retrospectively selected as the study subject.Patients with a total score of over 70 on the Barratt Impulsiveness Scale version 11(BIS-11),a weighted total score of less than 4 on the Modified Overt Aggression Scale(MOAS),and a score of 0 on the physical aggression item were included in the group with IAB.Patients with a BIS-11 total score of less than 70,a MOAS weighted total score of less than 5,and a physical aggression score of 0 were included in the group without IAB.This study used single voxel 1H-MRS to scan vmPFC and compared the ratios of N-acetyl-aspartate/creatine(NAA/Cr),choline/creatine(Cho/Cr),and myo-inositol/creatine(mI/Cr)in the vmPFC brain region of two groups of patients.Results There were 11 patients in the group with IAB and 12 patients in the group without IAB.The NAA/Cr values of ABD patients in the group with IAB were(1.45±0.16),lower than those in the group without IAB(1.69±0.08),and the difference was statistically significant(t=4.548,P<0.001).There was no statistically significant difference in the Cho/Cr and mI/Cr values[(0.64±0.10)vs(0.66±0.08),(0.49±0.19)vs(0.54±0.08)]between the two groups of patients(t=0.530,0.751;P>0.05).Conclusions The NAA/Cr values of patients with ABD and IAB decrease.The IAB of ABD patients may be related to a decrease in the density of vmPFC neurons or the presence of neuronal dysfunction.

关 键 词：青少年 双相情感障碍 抑郁发作 冲动攻击行为 磁共振波谱 

分 类 号：R749.4[医药卫生—神经病学与精神病学]